Provider / Organization | NPI | Date Certified |
---|---|---|
MELISSA CANNON | 1801292412 | 2021-10-10 |
Melissa Cannon is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1801292412. Registration indicates Melissa Cannon is a provider of access to adult/geriatric primary care providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (Physician Assistant, ) (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (All Other Specialties & Provider Types, ) (Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers)
Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
Entity Type | Individual |
Provider Name | Mrs. Melissa Cannon PA-C |
Practice Office Address | 1180 RESURGENCE DR STE 100 WATKINSVILLE, GA US |
Practice Office Telephone | 7065435858 |
Mailing Address | 1180 RESURGENCE DR STE 100 WATKINSVILLE, GA 306777211 US |
Business Telephone | 7065435858 |
Code | Practice | License No State |
---|---|---|
363A00000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician AssistantAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Physician Assistant Physician Assistants & Advanced Practice Nursing Providers Physician Assistant All Other Specialties & Provider Types Physician Assistant Physician Assistants & Advanced Practice Nursing Providers | 7337
GA |