MALLISA CANNON
NPI 1497180657
Licensed Practical Nurse in Novi, MI

Active since September 06, 2013
41621 W 11 MILE RD, NOVI, MI 48375(248) 299-0030 Get Directions Write a Review

NPPES record last updated: September 6, 2013. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Mallisa Cannon NPPES

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

MALLISA CANNON (NPI 1497180657) is an individual licensed practical nurse in Novi, Michigan, licensed in Michigan (4703111681) and active in the NPI registry since September 2013.

NPPES Registry Identity

NPI1497180657
Entity TypeIndividualFemale
Primary Taxonomy164W00000X
Provider Legal NameMALLISA CANNON
Location Address41621 W 11 MILE RDNovi, MI 48375-1804
Mailing Address5051 Buckingham AveDetroit, MI 48224-3250
Sole ProprietorNo
Enumeration DateSeptember 6, 2013
NPI 1497180657 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyLicensed Practical NurseNursing Service Providers
Taxonomy Code164W00000X
License Licensed in MI · 4703111681
Definition

A licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

41621 W 11 MILE RD, Novi, MI 48375

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.

Licensed Practical Nurse
41621 W 11 MILE RD
NOVI, MI 48375
Licensed Practical Nurse
41621 W 11 MILE RD
NOVI, MI 48375
Licensed Practical Nurse
41621 W 11 MILE RD
NOVI, MI 48375
Licensed Practical Nurse
41621 W 11 MILE RD
NOVI, MI 48375
Licensed Practical Nurse
41621 W 11 MILE RD
NOVI, MI 48375
Licensed Practical Nurse
41621 W 11 MILE RD
NOVI, MI 48375
Licensed Practical Nurse
41621 W 11 MILE RD
NOVI, MI 48375
Licensed Practical Nurse
41621 W 11 MILE RD
NOVI, MI 48375

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 Mallisa Cannon's NPI number?

The NPI number for Mallisa Cannon is 1497180657. It was assigned to this individual provider in the NPPES registry on September 6, 2013.

Where is Mallisa Cannon located?

Mallisa Cannon practices at 41621 W 11 Mile Rd, Novi, MI 48375. The listed phone number is (248) 299-0030.

What is Mallisa Cannon's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

When was this NPI record last updated?

The NPPES record for Mallisa Cannon was last updated on September 6, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.