Cannon, Katrina Terese

Cannon, Katrina Terese is an individual health care provider with primary practice located at 1345 W Central Park Ave Genesis Family Medicine Center, Davenport IA 52804-1844. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Geriatric Medicine. Allopathic & Osteopathic Physicians / Geriatric Medicine is her primary health care specialty. Cannon, Katrina Terese can be contacted via phone (563) 421-4400.

Contact Information

Primary practice address
1345 W Central Park Ave Genesis Family Medicine Center Davenport IA 52804-1844
Phone: (563) 421-4400
Fax: (563) 421-4449
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 35725 Iowa
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X 35725 Iowa

Profile Details

NPI number 1184734451
LBN Legal business name Cannon, Katrina Terese
Credentials MD, MS, CMD
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2006
Last updated Aug 1st, 2011 - about 15 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 1184734451 NPPES
Iowa MEDICAID 0732552
Iowa Other 26710

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