Cannon, Kimberly
Cannon, Kimberly is an sole proprietor health care provider with primary practice located at 28315 Harper Ave , Saint Clair Shores MI 48081-1687. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Cannon, Kimberly can be contacted via phone (586) 552-1710.Contact Information
Primary practice address
28315 Harper Ave
Saint Clair Shores MI 48081-1687
Phone: (586) 552-1710
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 4704259824 | Michigan |
Profile Details
| NPI number | 1578940656 |
|---|---|
| LBN Legal business name | Cannon, Kimberly |
| Credentials | AGPCNP-BC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 28th, 2015 |
| Last updated | Apr 28th, 2015 - about 9 years ago |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1578940656 | NPPES |
| Michigan | Other | 2014018630 | AMERICAN NURSES CREDENTIALING CENTER CERTIFICATION |
| Michigan | Other | 4704259824 | AMERICAN NURSES CREDENTIALING CENTER CERTIFICATION |
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