IndividualActive
Annie Cannon, PA-C
NPI 1225737513 · Surgical Physician Assistant · Park City, UT
Provider details
- NPI number
- 1225737513
- Entity type
- Individual
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- Yes
- License
- 14245481-1206 (UT)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
900 Round Valley Dr
Park City, UT 84060-7552
Phone: (435) 655-6600
Approximate (ZIP-level) locationGet directions
Mailing address
2648 E Casto Ln
Salt Lake City, UT 84117-6303
Registry dates
- Enumerated
- 2023-02-27
- Last updated
- 2025-11-09
- Certified
- 2025-11-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.