Doctor Name: | GINA CANNON |
NPI Number: | 1386015345 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | PN264410 |
Business Practice Address: | 1517 Durham Rd Penndel, PA - 190475707 |
Business Phone Number: | 2157521541 |
Business Fax Number: | 2157527195 |
Mailing Address: | 1517 Durham Rd, PENNDEL |
State: | PA |
Postal Code: | 190475707 |
Phone Number: | 2157521541 |
Fax Number: | 2157527195 |
NPI Enumeration Date: | 10/15/2015 |
NPI Last Update Date: | 10/15/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 164W00000X |
License Number: | PN264410 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Licensed Practical Nurse |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |