Gannon, Shanna M

Gannon, Shanna M is an individual health care provider with primary practice located at 2200 Whitney Ave Ste 270 , Hamden CT 06518-3694. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as her primary health care specialty. Gannon, Shanna M can be contacted via phone (203) 281-7000.

Contact Information

Primary practice address
2200 Whitney Ave Ste 270 Hamden CT 06518-3694
Phone: (203) 281-7000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 2318 Connecticut

Profile Details

NPI number 1639403892
LBN Legal business name Gannon, Shanna M
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 21st, 2009
Last updated Feb 14th, 2022 - about 4 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 1639403892 NPPES
Connecticut MEDICAID 003023181

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