Gannon, Carol A

Gannon, Carol A is an individual health care provider with primary practice located at 6801 W 20Th St Unit 101 , Greeley CO 80634-9640. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Gannon, Carol A can be contacted via phone (970) 378-8000.

Contact Information

Primary practice address
6801 W 20Th St Unit 101 Greeley CO 80634-9640
Phone: (970) 378-8000
Fax: (970) 378-8088
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X RN.0116733 Colorado
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X RXN.0099175-NP Colorado
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X APN.0002761-NP Colorado

Profile Details

NPI number 1538330113
LBN Legal business name Gannon, Carol A
Credentials Advanced Practice Nurse (APN)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 21st, 2008
Last updated Apr 28th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538330113 NPPES
Colorado MEDICAID 73426547

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