Cannon, Emily J

Cannon, Emily J is an individual health care provider with primary practice located at 619 S Fleishel Ave , Tyler TX 75701-2004. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Acute Care. Physician Assistants & Advanced Practice Nursing Providers / Acute Care is her primary health care specialty. Cannon, Emily J can be contacted via phone (903) 606-1264.

Contact Information

Primary practice address
619 S Fleishel Ave Tyler TX 75701-2004
Phone: (903) 606-1264
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X AP118873 Texas
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 723802 Texas

Profile Details

NPI number 1720319130
LBN Legal business name Cannon, Emily J
Credentials ACNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 25th, 2010
Last updated Jul 27th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720319130 NPPES
Texas Other P02469301 MEDICARE RAIL ROAD
Texas Other 1C3376 MEDICARE RAIL ROAD
Texas Other 8MK526 MEDICARE RAIL ROAD
Texas MEDICAID 398191220 MEDICARE RAIL ROAD

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