CHASE ANDREW CANNON PA NPI 1053877902

NPI Information

  • NPI: 1053877902
  • Provider Name: CHASE ANDREW CANNON, PA
  • Classification:
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 4700 LAS VEGAS BLVD N
    NELLIS AFB, NV
    ZIP 89191
  • Phone: (702) 653-2273

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NPI Details

Chase Andrew Cannon, PA is a healthcare provider in Nellis Afb, NV. Chase Andrew Cannon, PA NPI is 1053877902. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4700 LAS VEGAS BLVD N
NELLIS AFB, NV
ZIP 89191-600
Phone: (702) 653-2273

The NPI 1053877902 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 2/15/2019 and was last updated on 4/2/2025.

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
1363A00000XPhysician AssistantNo

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: 3/30/2025

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