Cannon Noles, Jennifer L

Cannon Noles, Jennifer L is an sole proprietor health care provider with primary practice located at 2545 N Eldorado Ave , Klamath Falls OR 97601-6423. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Cannon Noles, Jennifer L can be contacted via phone (541) 883-3471.

Contact Information

Primary practice address
2545 N Eldorado Ave Klamath Falls OR 97601-6423
Phone: (541) 883-3471
Fax: (541) 883-3524
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X

Profile Details

NPI number 1144511239
LBN Legal business name Cannon Noles, Jennifer L
Credentials BS
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 25th, 2011
Last updated Jan 28th, 2015 - about 10 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144511239 NPPES
Oregon MEDICAID 1114058898

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