| NPI | 1609612100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE EILEEN CANNON Pmhnp Bc, Fnp C, Ckns 520-800-9282 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-07-03 |
| Last Update Date | 2025-03-03 |