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NICOLE MARIE CANNON
NPI 1124313788
Substance Abuse Rehabilitation Facility in Tulsa, OK

Active since June 12, 2011
6333 E SKELLY DR, TULSA, OK 74135(918) 664-4224 Get Directions Write a Review

NPPES record last updated: June 12, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Nicole Marie Cannon NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICOLE MARIE CANNON (NPI 1124313788) is an individual substance abuse rehabilitation facility provider in Tulsa, Oklahoma and active in the NPI registry since June 2011.

NPPES Registry Identity

NPI1124313788
Entity TypeIndividualFemale
Primary Taxonomy324500000X
Provider Legal NameNICOLE MARIE CANNON
Location Address6333 E SKELLY DRTulsa, OK 74135-6106
Mailing Address1008 N Roosevelt AveSand Springs, OK 74063-7355 · (318) 805-3830
Phone(918) 664-4224
Sole ProprietorYes
Enumeration DateJune 12, 2011
✔ NPI 1124313788 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities
Taxonomy Code324500000X
Definition
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.
6333 E SKELLY DR, Tulsa, OK 74135
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JERRY LEE MANUS
Case Manager/Care Coordinator
6333 E SKELLY DR
TULSA, OK 74135
Tulsa County (918) 664-4224
KRYSTAL DAWN HUTCHINSON
Peer Specialist
6333 E SKELLY DR
TULSA, OK 74135
Tulsa County (918) 779-7216
MS. ABIGAIL ELIZABETH CARLISLE
Case Manager/Care Coordinator
6333 E SKELLY DR
TULSA, OK 74135
Tulsa County (000) 000-0000
TANYA CRAWFORD RN
Registered Nurse
6333 E SKELLY DR
TULSA, OK 74135
Tulsa County (918) 664-4224
KELLI ANN ORDORICA
Case Manager/Care Coordinator
6333 E SKELLY DR
TULSA, OK 74135
Tulsa County (918) 779-7151
JAYSON SWISHER
Peer Specialist
6333 E SKELLY DR
TULSA, OK 74135
Tulsa County (918) 664-4224
IVAN HONEYCUTT
Peer Specialist
6333 E SKELLY DR
TULSA, OK 74135
Tulsa County (918) 222-2222
GLORY S KALAKURCHA M.A.
Counselor (Addiction (Substance Use Disorder))
6333 E SKELLY DR
TULSA, OK 74135
Tulsa County (918) 664-4224

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicole Cannon's NPI number?

The NPI number for Nicole Cannon is 1124313788. It was assigned to this individual provider in the NPPES registry on June 12, 2011.

Where is Nicole Cannon located?

Nicole Cannon practices at 6333 E Skelly Dr, Tulsa, OK 74135. The listed phone number is (918) 664-4224.

What is Nicole Cannon's specialty?

The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

When was this NPI record last updated?

The NPPES record for Nicole Cannon was last updated on June 12, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.