MS. JACQUELYN DANETTE CANNON ARNP NPI 1558536490

NPI Information

NPI: 1558536490
Provider Name: MS. JACQUELYN DANETTE CANNON, ARNP
Classification: Nurse Practitioner - 363LA2100X
Entity Type: Individual

Specialization: Acute Care

Organization: UNIVERSITY OF FLORIDA JACKSONVILLE PHYSICIANS, INC.

PECOS Registration: Yes

Address:
1200 RIVERPLACE BLVD 620
JACKSONVILLE, FL
ZIP 32207
Phone: (904) 396-6620
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MS. Jacquelyn Danette Cannon, ARNP is an acute care nurse practitioner in Jacksonville, FL with 17 years of experience. MS. Jacquelyn Danette Cannon, ARNP NPI is 1558536490. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1200 RIVERPLACE BLVD 620
JACKSONVILLE, FL
ZIP 32207-803
Phone: (904) 396-6620
Fax: (904) 396-6528

The NPI 1558536490 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/22/2008 and was last updated on 7/29/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2100X	Nurse Practitioner	Acute Care	ARNP9169833	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	003104660A	MEDICAID	GEORGIA
2	0031120-00	MEDICAID	FLORIDA
3	AW451Y	MEDICARE PIN	FLORIDA
4	AW451Z	MEDICARE PIN	FLORIDA
5	AW451X	MEDICARE PIN	FLORIDA
6	ARNP9169833	OTHER	FLORIDA	FLORIDA BOARD OF NUSING LICENSE #
7	0004553-00	MEDICAID	FLORIDA
8	580304754A	MEDICAID	GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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