NPI Profile for STEPHANIE CANNON in WOODBURY, GA.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Primary Care |
363LP2300X | 50 | Nurse Practitioner | |
Adult Health |
363LA2200X | 50 | Nurse Practitioner | |
Gerontology |
363LG0600X | 50 | Nurse Practitioner |
| NPI # | 1710632302 |
|
| Status | Active | |
| Credentials | APRN (Advanced Practice Registered Nurse) | |
| Entity | Individual | |
| Enumeration date | 02/13/2022 | |
| Last updated | 10/15/2025 - About 8 months ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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STEPHANIE CANNON
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