Paula Gannon
Individual provider Active NPI Registered Nurse · Arnold, MO
NPI 1003200130 · NPPES record last updated Mar 26, 2015
Key facts
- NPI
- 1003200130
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 2007029761 (MO)
- Practice address
- 21 Municipal Dr
Arnold, MO 63010-1012 - Phone
- (636) 296-6206
- Fax
- (636) 296-0102
- NPI assigned
- Mar 26, 2015
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2007029761 | MO | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 2007029761 | MO | Yes |
Addresses
Primary practice location
21 Municipal Dr
Arnold, MO 63010-1012
Mailing address
227 E Main St
Festus, MO 63028-1952
Phone (636) 931-2700
Other providers in Arnold, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 26, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.