Organization · Type 2 NPI

Lorena Cannon LLC

Clinic/Center · Sandy, UT

NPI number 1235721879 Active

Practice location

893 E 9400 S
Sandy, UT 84094-3671

Specialties and licenses

Taxonomy	Code	License
Clinic/Center Primary	261Q00000X	None listed
Nurse Practitioner	363L00000X	None listed

Clinic/Center: A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

2 other providers at this address

Other clinic/center providers in Sandy

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NPI record

NPI: 1235721879
Entity type: Organization (Type 2)
Issued: Feb 4, 2021
Last updated: Mar 8, 2021
Status: Active

Other names

<unavail>
Peachtree Medical Care, LLC · doing business as
Peachtree Medical Clinic · doing business as

Authorized official

Lorena Cannon, APRN
Owner / Provider
(208) 351-5458

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1235721879

Lorena Cannon LLC's National Provider Identifier is 1235721879, issued on Feb 4, 2021. The primary taxonomy on file is Clinic/Center (261Q00000X), and the practice location is in Sandy, UT. The record was last updated on Mar 8, 2021.