Holly E Gannon, RNC, NNP

Primary specialty

Critical Care Medicine Nurse PractitionerTaxonomy code 363LC0200X

License

106839 Issued in MO

Practice address

1465 S Grand Blvd
Saint Louis, MO 63104-1003

Phone

(314) 268-2700

Fax

(314) 268-6474

NPI assigned

Apr 16, 2007

Last updated

Nov 19, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Physician Specialists of St Lukes LLC

  • Internal Medicine Physician
  • Chesterfield, MO
  • NPI 1235168410
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605744000000",
    "number": "1396960951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 AUBURN RIDGE CT",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633766865",
            "telephone_number": "636-922-9446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1465 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041003",
            "telephone_number": "314-268-2700",
            "fax_number": "314-268-6474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANNON",
        "first_name": "HOLLY",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "RNC, NNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "MO",
            "license": "106839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hgannon10186@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "hgannon10186@direct-ehr-ssmhc.com",
            "address_1": "1465 S Grand Blvd",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631041003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Folayemi Olubusayo Ganiyu, NP
• Mary Patricia Ganley, DC
• Maria Virginia Ganninger, MD
• Allison Gannon
• Elizabeth Gannon
• Nancy H Ganschinietz, CRNA
• James W Ganser, MSW
• Jessica Gansler
• Laura Anne Gantner, LPC, NCC
• Becky J. Ganz, ANP

• Critical Care Medicine Nurse Practitioner in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Critical Care Medicine Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.