STEPHANIE CANNON (NPI# 1730600396) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730600396 |
| Entity Type | Individual |
| Full Name | STEPHANIE CANNON |
| Credential | FNP-C |
| Practice Address |
100 E Wood St Ste 202 Spartanburg SC 29303-3058 |
| Mailing Address |
Po Box 743070 Atlanta GA 30374-3070 |
| Practice Telephone | 8645607070 |
| Practice Fax Number | 8645607073 |
| Mailing Telephone | 8645604304 |
| Mailing Fax Number | 8645604413 |
| Enumeration Date | 2017-07-03 |
| Last Update Date | 2018-02-13 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
21115 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | MEDICARE PIN | SCB4707628 | 01 |
| SC | NP4876 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 11 Five Fork Plaza Ct, Simpsonville, SC 296815460 | 8646270444 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730130261 | Stephanie Lynn Cannon | Registered Nurse | 3737 Maize Rd, Columbus, OH 43224-2604 | 2006-05-12 |
| 1225375801 | Stephanie D Cannon | Pharmacist | 23026 Panama City Beach Pkwy, Panama City Beach, FL 32413-1107 | 2013-01-15 |
| Street Address |
100 E WOOD ST STE 202 |
| City | SPARTANBURG |
| State | SC |
| Zip Code | 29303-3058 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164909446 | Jessica Ann Cash | Nurse Practitioner | 100 E Wood St Ste 202, Spartanburg, SC 29303-3058 | 2018-07-19 |
| 1457854796 | John Brandon Durham | Registered Nurse | 100 E Wood St Ste 202, Spartanburg, SC 29303 | 2018-03-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013532126 | Adam Joseph Fulcher | Family Medicine | Center for Family Medicine, 853 N. Church Street, Suite 510, Spartanburg, SC 29303 | 2020-06-15 |
| 1275011652 | Tri-state Medical Supplies, North Grove | Durable Medical Equipment & Medical Supplies | 1330 Boiling Springs Rd Ste 2900, Spartanburg, SC 29303 | 2018-07-30 |
| 1992227151 | Roxanne Pope | Speech-Language Pathologist | 290 N Grove Medical Park Dr., Spartanburg, SC 29303 | 2017-07-10 |
| 1861934879 | Cortney Redmond Mckinney I | Counselor | 250 Dewey Sve., Spartanburg, SC 29303 | 2016-11-08 |
| 1578011474 | Instride Foot and Ankle Specialists, Pllc | Podiatrist | 269 North Grove Medical Drive, Spartanburg, SC 29303 | 2016-09-20 |
| 1023477536 | Whitney Brooke Terry | Physician Assistant | 391 Serpentine Dr Ste 250, Spartanburg, SC 29303 | 2016-02-12 |
| 1306244348 | Medcare Urgent Care Spartanburg, LLC | Clinic/Center | 301 E Wood Street, Spartanburg, SC 29303 | 2014-12-08 |
| 1508201393 | Tom Ju | Anesthesiology | 1330 Boiling Springs Rd Ste 2700, Spartanburg, SC 29303 | 2013-05-07 |
| 1295072312 | Marie O'dell | Registered Nurse | 7 698 Howard Street, Spartanburg School District, Spartanburg, SC 29303 | 2013-01-09 |
| 1518203330 | Sherard Hamilton Ansley | Speech-Language Pathologist | 698 Howard St., Spartanburg School District 7, Spartanburg, SC 29303 | 2012-12-26 |
| Find all providers in zip 29303 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083231625 | Trisha Slaughter | Nurse Practitioner | 610 Adelaide Dr, Spartanburg, SC 29301-3231 | 2020-06-30 |
| 1891323457 | Jonathan Douglas Tester | Nurse Practitioner | 220 Police Club Rd, Spartanburg, SC 29303-3402 | 2020-03-30 |
| 1215455944 | Jasmine Marie Gregory | Nurse Practitioner | 300 E Blackstock Rd Ste E, Spartanburg, SC 29301-3787 | 2017-09-01 |
| 1538698030 | Deborah Temples Anderson | Nurse Practitioner | 11 Doctors Park Dr Ste 220, Spartanburg, SC 29307-1008 | 2017-06-08 |
| 1285181990 | Faustina Baafour Evans | Nurse Practitioner | 1855 E Main St Ste 21a, Spartanburg, SC 29307-2327 | 2016-09-10 |
| 1376995159 | Natalie Nicole Kellett | Nurse Practitioner | 120 Heywood Avenue Suite 200, Spartanburg, SC 29302 | 2016-07-06 |
| 1013372390 | Erin Lavette Farr | Nurse Practitioner | 2780 East Main Street, Ltc Health Solutions, Spartanburg, SC 29307 | 2015-12-30 |
| 1992170807 | Jaime Bright | Nurse Practitioner | 301 E Wood St, Spartanburg, SC 29303-3020 | 2015-12-02 |
| 1902273808 | Tamieka Latrell Alston-gibson | Nurse Practitioner | 101 North Pine Street, Suite 210, Spartanburg, SC 29302 | 2015-08-26 |
| 1922481712 | Sean Patrick Walsh | Nurse Practitioner | 2030 North Church Pl, Spartanburg, SC 29303-2799 | 2015-06-30 |
| Find all providers in SPARTANBURG | ||||
| City | SPARTANBURG |
| Zip Code | 29303 |
Please comment or provide details below to improve the information on STEPHANIE CANNON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.