Individual provider · NPI-1

Imani Patrice Cannon

Home Health Aide · Phoenix, AZ

NPI number1730735796
StatusActive
Last updated in NPPESAug 15, 2019

Details

NPI
1730735796
Entity type
Individual (NPI-1)
Name
Imani Patrice Cannon
Sex
Female
Sole proprietor
No
Enumeration date
Aug 15, 2019
Last updated
Aug 15, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
374U00000X Home Health Aide–AZYes

Practice location

7007 W Indian School Rd Apt 2143
Phoenix, AZ 85033-3387

Phone 602-475-2878

Mailing address

7007 W Indian School Rd Apt 2143
Phoenix, AZ 85033-3387

Phone 602-475-2878

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