Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 5007307 | NC |
NPI | 1003859158 |
---|---|
Provider Name | Dr. Sheila Nannette Cannon |
First Address | Leland, NC 28451-4193 |
Second Address | Shallotte, NC 28470-6501 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2006 |
Last Update Date | 09/02/2017 |