Provider Demographics
NPI:1578870523
Name:CANNON, CLAUDIA CAROLINA (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:CLAUDIA
Middle Name:CAROLINA
Last Name:CANNON
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:179 W CHESTNUT HILL RD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2210
Mailing Address - Country:US
Mailing Address - Phone:302-731-0828
Mailing Address - Fax:302-731-0027
Practice Address - Street 1:179 W CHESTNUT HILL RD
Practice Address - Street 2:SUITE 6
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2210
Practice Address - Country:US
Practice Address - Phone:302-731-0828
Practice Address - Fax:302-731-0027
Is Sole Proprietor?:No
Enumeration Date:2010-09-10
Last Update Date:2010-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG-0000537363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily