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NPI Code Detail

MEDICARE: EMILY CANNON FNP-C

MEDICARE: EMILY CANNON FNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician0024175823VA
2363LF0000XFamily Nurse Practitioner0024175823VA

General Provider Information

NPI Number : 1154820512
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY CANNON FNP-C
Provider Business Mailing Address
First Line : PO BOX 748613
Second Line :
City : ATLANTA
State : GA
Zip : 30384-8613
Country : US
Telephone Number : 434-295-1000
Fax Number :
Provider Business Practice Location Address
First Line : 493 BLACKWELL RD STE 202
Second Line :
City : WARRENTON
State : VA
Zip : 20186-2689
Country : US
Telephone Number : 540-347-4400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2018
Last Update Date : 11/05/2024

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Directions to “ EMILY CANNON FNP-C” Practice Location

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