MEDICARE: MICHELLE CANNINGTON

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	363LF0000X	Family Nurse Practitioner	ARNP9325924	FL
2	363LF0000X	Family Nurse Practitioner	RN263318	GA

General Provider Information

NPI Number	:	1942750401
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE CANNINGTON

Provider Business Mailing Address
First Line	:	2007 ABBEY COURT
Second Line	:
City	:	ALPHARETTA
State	:	GA
Zip	:	30004-6024
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2700 ABBEY COURT
Second Line	:
City	:	ALPHARETTA
State	:	GA
Zip	:	30004-3400
Country	:	US
Telephone Number	:	770-772-4233
Fax Number	:

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

Provider Enumeration Date	:	10/09/2016
Last Update Date	:	02/02/2017

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Directions to “ MICHELLE CANNINGTON ” Practice Location

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