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NPI Code Detail

MEDICARE: KENYA CANNONIER FNP-BC, PMHNP-BC

MEDICARE: KENYA CANNONIER FNP-BC, PMHNP-BC
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner26NJ00564600NJ
22084P0800XPsychiatry Physician26NJ00564600NJ
3363LF0000XFamily Nurse Practitioner26NJ00564600NJ

General Provider Information

NPI Number : 1043607658
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENYA CANNONIER FNP-BC, PMHNP-BC
Provider Business Mailing Address
First Line : PO BOX 748465
Second Line :
City : ATLANTA
State : GA
Zip : 30374-8465
Country : US
Telephone Number : 855-284-7483
Fax Number :
Provider Business Practice Location Address
First Line : PO BOX 748465
Second Line :
City : ATLANTA
State : GA
Zip : 30374-8465
Country : US
Telephone Number : 855-284-7483
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2015
Last Update Date : 01/29/2026

Similar Medicare Providers

1023851334 — MAITE REECE MA, PSYD
Practice Location Address:
PO BOX 748465
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Practice Phone: 855-284-7483
Practice Fax: 617-807-0958
1922399484 — MRS. TIFFANY M. AFFLALO-WILLIAMS LPC
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PO BOX 748465
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1932482296 — MRS. REESHA FAYE JEANETTE MONTGOMERY LMFT
Practice Location Address:
PO BOX 748465
ATLANTA, GA
30374-8465
Practice Phone: 855-284-7483
Practice Fax:
1053795435 — TINA S. CHAVIS FNP, PMHNP
Practice Location Address:
PO BOX 748465
ATLANTA, GA
30374-8465
Practice Phone: 855-284-7483
Practice Fax:
1861850562 — LYNN A MCCORMICK
Practice Location Address:
PO BOX 748465
ATLANTA, GA
30374-8465
Practice Phone: 855-284-7483
Practice Fax:
1114431947 — MR. THOMAS J SOWERS LCSW
Practice Location Address:
PO BOX 748465
ATLANTA, GA
30374-8465
Practice Phone: 855-284-7483
Practice Fax: 617-807-0958

Directions to “ KENYA CANNONIER FNP-BC, PMHNP-BC” Practice Location

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