Provider Demographics
NPI:1073078465
Name:CANNON, ELIZABETH I (CNM)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:I
Last Name:CANNON
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9195 GRANT ST STE 410
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80229-4388
Mailing Address - Country:US
Mailing Address - Phone:303-280-2229
Mailing Address - Fax:303-280-0765
Practice Address - Street 1:9195 GRANT ST STE 410
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-4388
Practice Address - Country:US
Practice Address - Phone:303-280-2229
Practice Address - Fax:303-280-0765
Is Sole Proprietor?:No
Enumeration Date:2019-02-10
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
COAPN.0994130-CNM367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife