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

Shannon Cannon

Individual provider Registered Nurse · NPI 1417431263

Shannon Cannon is a Nurse Practitioner in Media, Pennsylvania. Qualified in 2024, 2 years ago. Licensed in Pennsylvania.

Years since qualifying
2
Licensed in
PA
In the registry since
2018
Specialties on file
2
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Practice location Address checks out

100 Yearsley Mill Rd
Media, PA 19063-5593
Phone: (888) 227-3898
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence SPO30927 (PA)
Registered Nurse Taxonomy 163W00000X · Licence RN627631 (PA)

Record details

NPI number1417431263
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedSeptember 18, 2018
Last updated in NPPESJanuary 22, 2025
Certification dateJanuary 22, 2025
Mailing address812r Crum Creek Rd, Springfield, PA 19064-1037

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 Not indicated

Other providers in Media