Provider Demographics
NPI:1386494946
Name:CANN HEALTH SERVICES LLC
Entity type:Organization
Organization Name:CANN HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:CANN
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:227-226-7864
Mailing Address - Street 1:2502 URBANA PIKE STE 103
Mailing Address - Street 2:
Mailing Address - City:IJAMSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21754-8602
Mailing Address - Country:US
Mailing Address - Phone:227-226-7864
Mailing Address - Fax:301-235-1689
Practice Address - Street 1:2502 URBANA PIKE STE 103
Practice Address - Street 2:
Practice Address - City:IJAMSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21754-8602
Practice Address - Country:US
Practice Address - Phone:227-226-7864
Practice Address - Fax:301-235-1689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-26
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty