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Contact Information

SPENCER CANNON, RN
161 S DOOLEY CT
SALT LAKE CITY, UT84102-4104
 Phone: 801-696-8513
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

363LP0200X 50 Nurse Practitioner
 

Pediatrics

163WP0200X
 

Registered Nurse

163W00000X
Indicates primary specialty

NPI Profile & details for SPENCER CANNON · (Male)

NPI # 1346525201
Status Active
Credentials RN (Registered Nurse)
Entity Individual
Enumeration date 10/11/2011
Last updated 03/04/2024 - About 2 years ago
Sole proprietor 1 No
Identifiers
  • UT License # 8038048-3102
  • UT License # 8038048-4405
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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