Gannon, Kathleen Rita
Gannon, Kathleen Rita is an individual health care provider with primary practice located at 1810 Sw White Birch Circle Ste 111, Ankeny IA 50023-7226. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Geriatric Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. Gannon, Kathleen Rita can be contacted via phone (515) 964-7115.Contact Information
Primary practice address
1810 Sw White Birch Circle Ste 111
Ankeny IA 50023-7226
Phone: (515) 964-7115
Fax: (515) 964-7899
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | T2006-010 | Arkansas |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 03077 | Iowa |
| Allopathic & Osteopathic Physicians / Geriatric Medicine | 207RG0300X | 03077 | Iowa |
Profile Details
| NPI number | 1922066331 |
|---|---|
| LBN Legal business name | Gannon, Kathleen Rita |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 3rd, 2006 |
| Last updated | Jul 11th, 2011 - about 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1922066331 | NPPES |
| Arkansas | MEDICAID | 159949003 | |
| Arkansas | MEDICAID | 9170589 |
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