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NPI Code Detail

MEDICARE: KA'DASIA CANNON

MEDICARE: KA'DASIA CANNON
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1265319966
Entity Type Code : Individual
Provider Name (Legal Business Name) : KA'DASIA CANNON
Provider Business Mailing Address
First Line : 600 SUPERIOR AVE STE 2610
Second Line :
City : CLEVELAND
State : OH
Zip : 44114-2692
Country : US
Telephone Number : 440-819-1603
Fax Number :
Provider Business Practice Location Address
First Line : 600 SUPERIOR AVE STE 2610
Second Line :
City : CLEVELAND
State : OH
Zip : 44114-2692
Country : US
Telephone Number : 440-819-1603
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2025
Last Update Date : 08/18/2025

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Directions to “ KA'DASIA CANNON ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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