Healthcare Provider Details

I. General information

NPI: 1003859158
Provider Name (Legal Business Name): SHEILA NANNETTE CANNON PMHNP/PMHCNS-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SHEILA CANNON PMHNP, BC

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 09/12/2023
Certification Date: 09/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 W COMMONS BLVD
NEW CASTLE DE
19720-2419
US

IV. Provider business mailing address

100 GARDENGATE RD
CAMDEN DE
19934-9648
US

V. Phone/Fax

Practice location:
  • Phone: 302-224-1400
  • Fax:
Mailing address:
  • Phone: 757-478-4372
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number2512129
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberL1-0072437
License Number StateDE
# 3
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number271878
License Number StateMA
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number5007307
License Number StateNC
# 5
Primary TaxonomyN
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberLE-0010201
License Number StateDE
# 6
Primary TaxonomyN
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number319
License Number StateNC
# 7
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberL8-0010452
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: