Ericia Latrice Cannon, NURSE PRACTITONER
NPI #1013473891 in Jackson, Mississippi
Provider Information
- NPI Number
- 1013473891
- Entity Type
- Individual
- Name
- Ericia Latrice Cannon, NURSE PRACTITONER
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Nurse Practitioner - Family
- Credential
- NURSE PRACTITONER
- Enumeration Date
- Feb 16, 2019
- Last Updated
- Mar 7, 2019
Practice Location
- Address
- 3502 W NORTHSIDE DR
- City
- Jackson
- State
- Mississippi
- ZIP Code
- 39213-4454
- Phone
- (601) 362-5321
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner - Family — Family |
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