Patricia Ann Cannon, RN

Individual provider Active NPI Community Health Registered Nurse · College Park, GA

NPI 1245398254 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1245398254
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Registered Nurse 163WC1500X
License
RN058107 (GA)
Practice address
1920 John Wesley Drive
College Park, GA 30337
Phone
(404) 765-4155
Fax
(404) 765-4149
NPI assigned
Dec 4, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN058107GAMDCommunity Health Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X RN058107 GA Yes

Addresses

Primary practice location

1920 John Wesley Drive
College Park, GA 30337

Mailing address

99 Jesse Hill Jr Dr SE
Atlanta, GA 35303
Phone (404) 473-0121

Other names

  • Miss Patricia Ann Peterson Former name

Other providers in College Park, GA

All providers in College Park, GA · Community Health Registered Nurse in Georgia

Sources for this page

Verify at the official NPI Registry.