Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kathryn Nannette Cannon

Individual provider Physician Assistant · NPI 1518523836

Kathryn Nannette Cannon is a Physician Assistant in Orange Park, Florida. Qualified in 2019, 7 years ago. Practices with St Vincent's Ambulatory Care Inc, a 302-clinician group. Licensed in Florida.

Years since qualifying
7
Licensed in
FL
In the registry since
2019
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Practice location Address checks out

2300 Park Ave Ste 200
Orange Park, FL 32073-5571
Phone: (904) 296-2900
Fax: (904) 296-1140
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA9112385 (FL)

Record details

NPI number1518523836
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMay 13, 2019
Last updated in NPPESOctober 28, 2019

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice St Vincent'S Ambulatory Care Inc — 302 clinicians
Accepts Medicare assignment Not indicated
Practice locations4 on file with Medicare

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