Cannon, Jacquelyn Danette

Cannon, Jacquelyn Danette is an individual health care provider with primary practice located at 11513 N Main St , Jacksonville FL 32218-4002. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Acute Care, which is considered as her primary health care specialty. Cannon, Jacquelyn Danette can be contacted via phone (855) 674-7400.

Contact Information

Primary practice address
11513 N Main St Jacksonville FL 32218-4002
Phone: (855) 674-7400
Fax: (904) 730-1037
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X ARNP9169833 Florida

Profile Details

NPI number 1558536490
LBN Legal business name Cannon, Jacquelyn Danette
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 22nd, 2008
Last updated Nov 7th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558536490 NPPES
Florida Other ARNP9169833 FLORIDA BOARD OF NUSING LICENSE #
Florida MEDICAID 580304754A FLORIDA BOARD OF NUSING LICENSE #
Florida MEDICAID 0031120-00 FLORIDA BOARD OF NUSING LICENSE #

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