NICOLE M. CANNON – NPI #1124313788
Substance Abuse Rehabilitation Facility

A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

NICOLE CANNON is a substance abuse rehabilitation facility located in TULSA, OK. NPPES has assigned the NPI number 1124313788 to NICOLE CANNON on June 12, 2011. It is a Type-1 NPI, indicating this NPI number is associated with an individual. The primary taxonomy selected by this provider is 324500000X from the Health Care Provider Taxonomy code set, which is classified as Substance Abuse Rehabilitation Facility.

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for NICOLE CANNON below.

NPI Profile for
NICOLE M. CANNON

NPI Number
1124313788
Enumeration Date

(about 15 years ago)
Entity Type
Type-1  Individual (Female)
Legal Name
NICOLE M. CANNON
Primary location
6333 E SKELLY DR
TULSA, OK 74135-6106
Phone: (918) 664-4224 Fax:
Mailing address
1008 N ROOSEVELT AVE
SAND SPRINGS, OK 74063-7355
Phone: (318) 805-3830 Fax:
Sole Proprietor
Yes
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
324500000X
- Substance Abuse Rehabilitation Facility (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.