MEDICARE: NYDIA CANNON RN, APRN

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
1	163W00000X	Registered Nurse	215680	LA
2	363LP2300X	Primary Care Nurse Practitioner	215680	LA

General Provider Information

NPI Number	:	1679143507
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NYDIA CANNON RN, APRN

Provider Business Mailing Address
First Line	:	223 CESSNA DR
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71106-3421
Country	:	US
Telephone Number	:	318-350-7402
Fax Number	:

Provider Business Practice Location Address
First Line	:	223 CESSNA DR
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71106-3421
Country	:	US
Telephone Number	:	318-350-7402
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2021
Last Update Date	:	06/24/2026

Similar Medicare Providers

1114853868 — LIPIKA CHAKRABARTY
Practice Location Address:

10450 ELLERBE RD
SHREVEPORT, LA
71106-7730

Practice Phone: 318-797-8500
Practice Fax:

1023632098 — DR. HARISH TUMMALA MD, DMD
Practice Location Address:

385 BERT KOUNS INDUSTRIAL LOOP
SHREVEPORT, LA
71106-8158

Practice Phone: 318-524-7736
Practice Fax:

1063868750 — RAINA W CALDWELL
Practice Location Address:

277 HARDERS CROSSING BLVD
SHREVEPORT, LA
71106-8526

Practice Phone: 318-840-7810
Practice Fax:

1962336289 — LADARIUS TURER
Practice Location Address:

491 DIXON ST
SHREVEPORT, LA
71106-7808

Practice Phone: 318-458-2666
Practice Fax:

1184556607 — CITY TOO CITY TRANSPORTATION LLC
Practice Location Address:

232 W 73RD ST
SHREVEPORT, LA
71106-4202

Practice Phone: 318-540-8985
Practice Fax:

1477925063 — HIGHLAND CLINIC, A PROF MED CORP
Practice Location Address:

471 ASHLEY RIDGE BLVD
SHREVEPORT, LA
71106-7229

Practice Phone: 318-795-4770
Practice Fax: 318-795-4775

Directions to “ NYDIA CANNON RN, APRN” Practice Location

Language	Start Address	Practice Location

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.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.