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General NPI Number Information
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NPI Number | 1750299715
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Entity Type | Individual
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Provider Name | MERCEDES CANNON
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Gender | Female
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Dates
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Enumeration Date | 08/31/2026
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Last Update Date | 08/31/2026
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Provider Practice Location Address
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Address Line | 5308 HARROUN RD STE 55
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City | SYLVANIA
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State | OH
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Zip | 43560-2174
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Country | US
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Telephone | 419-824-6599
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Fax |
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Provider Business Mailing Address
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Address Line | 557 W RIVER ST
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City | DEERFIELD
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State | MI
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Zip | 49238-9632
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WX0200X
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Taxonomy Name | Oncology Registered Nurse
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License Number | 459935
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License Number State | OH
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