Kimberly Cannon, FNP-BC
NPI 1407375207 · Family Nurse Practitioner · Jackson, MI
Enrolled with Medicare as Practitioner - Nurse Practitioner · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Provider details
- NPI number
- 1407375207
- Entity type
- Individual
- Primary specialty
- Family Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- FNP-BC
- Sex
- Female
- Sole proprietor
- Yes
- License
- 4704304007 (MI)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
3 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (2)
- 30999 Morlock St # 924Livonia, MI 48152-1662Phone: (313) 713-4543Fax: (313) 713-4543
- 30999 Morlock St # 924Livonia, MI 48152-1662Phone: (313) 713-4543Fax: (313) 713-4543
Registry dates
- Enumerated
- 2017-09-12
- Last updated
- 2018-03-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.