Provider Demographics
NPI:1003285305
Name:CANNON, BRITTANY L (APN)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:L
Last Name:CANNON
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:L
Other - Last Name:PRYOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:108 GRIFFITH ST
Mailing Address - Street 2:
Mailing Address - City:SALE CREEK
Mailing Address - State:TN
Mailing Address - Zip Code:37373-9715
Mailing Address - Country:US
Mailing Address - Phone:423-498-3570
Mailing Address - Fax:423-648-7542
Practice Address - Street 1:108 GRIFFITH ST
Practice Address - Street 2:
Practice Address - City:SALE CREEK
Practice Address - State:TN
Practice Address - Zip Code:37373-9715
Practice Address - Country:US
Practice Address - Phone:423-332-1813
Practice Address - Fax:423-648-7542
Is Sole Proprietor?:No
Enumeration Date:2015-09-17
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN20250363LA2100X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN20250OtherAPN LICENSE