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MICHELLE R. CANNON PA-C
NPI 1609839125
Physician Assistant - Medical in Statesville, NC

Active since April 07, 2006
619 SULLIVAN RD, STATESVILLE, NC 28677(704) 878-9309 Get Directions Write a Review

NPPES record last updated: January 23, 2008. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Michelle R. Cannon Pa-c NPPES

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

MICHELLE R. CANNON PA-C (NPI 1609839125) is an individual medical provider in Statesville, North Carolina, licensed in North Carolina (102143) and active in the NPI registry since April 2006.

NPPES Registry Identity

NPI1609839125
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameMICHELLE R. CANNONCredential: PA-C
Location Address619 SULLIVAN RDStatesville, NC 28677-3437
Mailing Address650 Signal Hill Drive Ext, P.o. Box 1845Statesville, NC 28625-4353 · (704) 873-4277
Phone(704) 878-9309
Sole ProprietorNo
Enumeration DateApril 7, 2006
Last NPPES UpdateJanuary 23, 2008
✔ NPI 1609839125 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in NC · 102143
619 SULLIVAN RD, Statesville, NC 28677
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Other Identifiers 2

Medicare ID-Type Unspecified2752721NC
Medicare UPINS97750NC

Other Providers at the Same Location NPPES 14

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

CHRISTINA SHELBY BOLAND LCSW
Social Worker (Clinical)
619 SULLIVAN RD
STATESVILLE, NC 28677
Iredell County (704) 871-0934
BUCKLEY OLSEN
Social Worker (Clinical)
619 SULLIVAN RD
STATESVILLE, NC 28677
Iredell County (847) 454-6393
LORALIN MARIE KELLER-SOUNDARA LCSW-A
Social Worker (Clinical)
619 SULLIVAN RD
STATESVILLE, NC 28677
Iredell County (704) 871-0934
SHIRLEY JEAN LAWRENCE CADC
Counselor (Addiction (Substance Use Disorder))
619 SULLIVAN RD
STATESVILLE, NC 28677
Iredell County (704) 871-0934
CHRISTIANA OBIAMAKA ODUAH-THOMAS RN
Registered Nurse
619 SULLIVAN RD
STATESVILLE, NC 28677
Iredell County (704) 871-0934
PHOEBE IRELAND PRUNEDA LCSW-A
Social Worker (Clinical)
619 SULLIVAN RD
STATESVILLE, NC 28677
Iredell County (704) 871-0934
MARY MAIKRANZ MARKS NP
Nurse Practitioner (Family)
619 SULLIVAN RD
STATESVILLE, NC 28677
Iredell County (704) 924-9111
FRANK J SPENCE JR. MD
Family Medicine
619 SULLIVAN RD
STATESVILLE, NC 28677
Iredell County (704) 924-9111

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 Michelle Cannon's NPI number?

The NPI number for Michelle Cannon is 1609839125. It was assigned to this individual provider in the NPPES registry on April 7, 2006.

Where is Michelle Cannon located?

Michelle Cannon practices at 619 Sullivan Rd, Statesville, NC 28677. The listed phone number is (704) 878-9309.

What is Michelle Cannon's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

When was this NPI record last updated?

The NPPES record for Michelle Cannon was last updated on January 23, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.