| NPI | 1700745692 |
|---|---|
| Former Name | SHANNON LEE CANNON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 239107) |
| Enumeration Date | 2026-01-17 |
| Last Update Date | 2026-01-17 |