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1013389022
IZEGBEA M. CANNON
LOUISVILLE, KY
NPI
1013389022
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: KY 3009546)
Enumeration Date
2015-10-29
Last Update Date
2015-10-29
Business Address
-- IZEGBEA M. CANNON
2215 PORTLAND AVE
LOUISVILLE, KY 40212-1033
Phone number: 502-774-8631
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Mailing Address
-- IZEGBEA M. CANNON
2215 PORTLAND AVE
LOUISVILLE, KY 40212-1033
Phone number: 502-774-8631
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