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

Rubaba Cannon

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1073964458

Rubaba Cannon is a Nurse Practitioner in Atlanta, Georgia. Qualified in 2024, 2 years ago. Accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
2
Licensed in
GA
In the registry since
2016

Practice location Address checks out

3621 Vinings Slope SE Unit 1332
Atlanta, GA 30339-4168
Phone: (404) 307-9691
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence RN242262 (GA)

Record details

NPI number1073964458
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 27, 2016
Last updated in NPPESJanuary 29, 2025
Certification dateJanuary 29, 2025

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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