Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 9229514 | FL |
NPI | 1003321209 |
---|---|
Provider Name | Sarah Jacquoline Cannon |
First Address | Spring Hill, FL 34609-8102 |
Second Address | Palm Harbor, FL 34683-1926 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/12/2017 |
Last Update Date | 15/12/2021 |