Provider Demographics
NPI:1952112088
Name:CANNON, EMILY JOANNA (DNP, RN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:JOANNA
Last Name:CANNON
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Gender:F
Credentials:DNP, RN, PMHNP-BC
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Mailing Address - Street 1:7480 WOODCRAFT LN
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47802-9815
Mailing Address - Country:US
Mailing Address - Phone:812-243-3991
Mailing Address - Fax:812-645-3778
Practice Address - Street 1:6325 S STATE ROAD 46
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802-8917
Practice Address - Country:US
Practice Address - Phone:812-214-5452
Practice Address - Fax:812-645-3778
Is Sole Proprietor?:No
Enumeration Date:2025-01-17
Last Update Date:2025-02-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN71016274A363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health