Mrs Kimberly Cannon, AGPCNP-BC in Saint Clair Shores, MI

Mrs Kimberly Cannon, AGPCNP-BC is a medicare enrolled "Nurse Practitioner" in Saint Clair Shores, Michigan. Her current practice location is 28315 Harper Ave, Saint Clair Shores, Michigan. You can reach out to her office (for appointments etc.) via phone at (586) 552-1710.

Mrs Kimberly Cannon is licensed to practice in Michigan (license number 4704259824) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1578940656.

Contact Information

	Mrs Kimberly Cannon, AGPCNP-BC
	28315 Harper Ave, Saint Clair Shores, MI 48081-1687
	(586) 552-1710
	Not Available

Map and Direction

Provider's Profile

Full Name	Mrs Kimberly Cannon
Gender	Female
Speciality	Nurse Practitioner
Location	28315 Harper Ave, Saint Clair Shores, Michigan
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1578940656
Provider Enumeration Date: 04/28/2015
Last Update Date: 04/28/2015

Medicare PECOS Information:

PECOS PAC ID: 9133426885
Enrollment ID: I20160324001031

Medical Identifiers

Medical identifiers for Mrs Kimberly Cannon such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1578940656	NPI	-	NPPES
2014018630	Other	MI	AMERICAN NURSES CREDENTIALING CENTER CERTIFICATION
4704259824	Other	MI	STATE OF MICHIGAN, BOARD OF NURSING, NURSE PRACTITIONER LICENSE

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	4704259824 (Michigan)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Kimberly Cannon is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mrs Kimberly Cannon, AGPCNP-BC 28315 Harper Ave, Saint Clair Shores, MI 48081-1687 Ph: (586) 552-1710	Mrs Kimberly Cannon, AGPCNP-BC 28315 Harper Ave, Saint Clair Shores, MI 48081-1687 Ph: (586) 552-1710

Reviews and Comments

Nurse Practitioner Nurses in Saint Clair Shores, MI

Nicole Irene Back, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 22213 Love St, Saint Clair Shores, MI 48082 Phone: 734-626-4672
Carrie L Anderson, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 20952 E 12 Mile Rd Ste 200, Saint Clair Shores, MI 48081 Phone: 586-771-4820 Fax: 586-771-6620
Jennifer Kulinski, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 24800 Ursuline St, Saint Clair Shores, MI 48080 Phone: 586-945-5088
Mrs. Ayesha Massey Bennett, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 25200 Little Mack Ave, Saint Clair Shores, MI 48081 Phone: 586-884-5656
Meghan Martinovski, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 25200 Little Mack Ave, Saint Clair Shores, MI 48081 Phone: 586-884-5656
Mr. Ronald August Bonaventura Jr., Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 22432 Harper Lake Ave, Saint Clair Shores, MI 48080 Phone: 586-557-8398
Patricia West, PHD, RN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 24911 Little Mack Ave, Suite C, Saint Clair Shores, MI 48080 Phone: 586-447-9070

Mrs Kimberly Cannon, AGPCNP-BC - Medicare Nurse Practitioner in Saint Clair Shores, MI