MRS. JAIMIE SUZANNE CANNON (NPI# 1902297880) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1902297880 |
Entity Type | Individual |
Full Name | MRS. JAIMIE SUZANNE CANNON |
Credential | MSN, APRN, FNP-C |
Practice Address |
6468 State Highway 77 Benton MO 63736-8237 |
Practice Telephone | 5735453565 |
Practice Fax Number | 5735453491 |
Mailing Telephone | 5735453565 |
Mailing Fax Number | 5735453491 |
Enumeration Date | 2015-02-12 |
Last Update Date | 2015-02-12 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
2015004268 | MO | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
6468 STATE HIGHWAY 77 |
City | BENTON |
State | MO |
Zip Code | 63736-8237 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1427385376 | Amber Nicole Thorne | Nurse Practitioner | 6468 State Highway 77, Benton, MO 63736-8237 | 2009-11-13 |
1609230507 | Missouri Delta Medical Center | Clinic/Center | 6468 State Highway 77, Benton, MO 63736-8237 | 2016-04-07 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528348778 | Southeast Missouri Health Network | Dentist | 6724 Highway 77 E, Benton, MO 63736 | 2011-08-19 |
1245415389 | Comprehensive Family Health Care LLC | Family Medicine | 142 S Winchester St, Benton, MO 63736-0000 | 2008-01-08 |
1699084814 | Travis James Weiss | Physician Assistant | 6724 State Highway 77, Benton, MO 63736-8238 | 2010-10-05 |
1932108974 | Southeast Missouri Health Network | Clinic/Center | 6738 State Highway 77, Benton, MO 63736-8238 | 2005-07-20 |
1992048961 | Jessica Pickel | Dental Hygienist | 6724 State Highway 77, Benton, MO 63736-8238 | 2013-03-28 |
1497035661 | Southeast Missouri Health Network | Clinic/Center | 6724 State Highway 77, Benton, MO 63736-8238 | 2011-08-19 |
1366514523 | Scott County R-iv School District | Physical Therapist | 4035 State Highway 77, Benton, MO 63736-9162 | 2006-11-14 |
1407489727 | Lana Jean Atkins | Speech-Language Pathologist | 4035 State Highway 77, Benton, MO 63736-9162 | 2020-02-14 |
1043686546 | A & A In-home Health Care, LLC | Home Health | 568 County Highway 504, Benton, MO 63736-9193 | 2015-08-19 |
1275134264 | Stephanie Suzanne Worth | Physical Therapy Assistant | 135 Meyers Lake Ct, Benton, MO 63736-9201 | 2020-11-05 |
Find all providers in zip 63736 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710525720 | Melanie Mabry | Nurse Practitioner | 11510 State Highway 298, Benton, AR 72019 | 2019-12-20 |
1538625900 | Morgan Dyanne Colson | Nurse Practitioner | 1576 Brookshire Dr, Benton, AR 72019-9547 | 2019-02-11 |
1639648041 | Laurie Jeannette Kerschner | Nurse Practitioner | 166 Wellivers Hill Rd, Benton, PA 17814-8131 | 2018-11-14 |
1790253326 | Seth Alexander Weisheit | Nurse Practitioner | 824 Military Road, Benton, AR 72015 | 2018-11-13 |
1982171484 | Reanna Christine Hargrove | Nurse Practitioner | 2314 Olive Creek Rd, Benton, KY 42025-4208 | 2018-11-01 |
1710474093 | Carmacare Inc | Nurse Practitioner | 2408 Military Rd, Benton, AR 72015-2743 | 2018-04-23 |
1366950693 | Blake Borders | Nurse Practitioner | 222 Bland St, Benton, MO 63736-9206 | 2018-01-22 |
1063920452 | Pamela Ann Bates | Nurse Practitioner | 824 Military Rd, Benton, AR 72015-3347 | 2018-01-19 |
1023525490 | Kortney Kai Spann | Nurse Practitioner | 4110 Darla Dr, Benton, AR 72015-6299 | 2018-01-05 |
1548791510 | Monica Suzanne Williams | Nurse Practitioner | 10676 Hinds Rd, Benton, AR 72019-9442 | 2017-03-22 |
Find all providers in BENTON |
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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.