JENNIFER NICOLE GANNON (NPI# 1447308770) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447308770 |
| Entity Type | Individual |
| Full Name | JENNIFER NICOLE GANNON |
| Credential | PA-C |
| Practice Address |
30 Railroad Ave Centracare Clinic Albany Albany MN 56307-9363 |
| Mailing Address |
30 Railroad Ave Albany MN 56307-9379 |
| Practice Telephone | 3208452157 |
| Practice Fax Number | 3208456138 |
| Mailing Telephone | 3208452157 |
| Mailing Fax Number | 3208456138 |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2020-08-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
1881 | MN | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 363A00000X | Physician Assistant | 11639 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699899567 | Jennifer Gannon | Pharmacist | 4151 S Canton Center Rd, Canton, MI 48188-2489 | 2007-03-18 |
| 1194721241 | Jennifer Sakura Gannon | Optometrist | Blackfeet Community Hospital Eye Clinic, Hopsital Circle, Browning, MT 59417 | 2005-06-23 |
| 1598324949 | Jennifer Gannon | Registered Nurse | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2019-06-10 |
| 1619535648 | Jennifer Gannon | Case Manager/Care Coordinator | 445 E Dublin Granville Rd Ste G, Worthington, OH 43085-3183 | 2019-06-04 |
| 1780121327 | Jennifer Gannon | Student in an Organized Health Care Education/Training Program | 8000 York Rd, Towson University, Towson, MD 21252-0001 | 2017-01-20 |
| 1619396991 | Jennifer Gannon | Case Manager/Care Coordinator | 1804 S Eddy St, Grand Island, NE 68801-7114 | 2014-04-15 |
| 1740218270 | Jennifer L Gannon | Medical Genetics | 5808 W 110th St, Overland Park, KS 66211-2504 | 2006-06-30 |
| 1346287042 | Jennifer Botte Gannon | Obstetrics & Gynecology | Mount Kisco Medical Group PC, 90 South Bedford Rd, Mount Kisco, NY 10549-3412 | 2006-06-01 |
| 1396703575 | Jennifer S Gannon | Physician Assistant | 501 W 7th St, Frederick, MD 21701-4586 | 2006-05-03 |
| Street Address |
30 RAILROAD AVE CENTRACARE CLINIC ALBANY |
| City | ALBANY |
| State | MN |
| Zip Code | 56307-9363 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952874836 | Tess Marie King | Physician Assistant | 30 Railroad Ave, Albany, MN 56307-9379 | 2019-01-03 |
| 1649758079 | Hailey Brinkman | Physical Therapist | 30 Railroad Ave, Albany, MN 56307-9379 | 2018-07-28 |
| 1871035881 | Stephanie Ann Olson | Registered Nurse | 30 Railroad Ave, Albany, MN 56307-9379 | 2016-11-08 |
| 1720432057 | Brittany Nagel | Family Medicine | 30 Railroad Ave, Albany, MN 56307-9379 | 2016-04-22 |
| 1609241447 | St. Cloud Hospital | Clinic/Center | 30 Railroad Ave, Albany, MN 56307-9379 | 2015-12-04 |
| 1457726549 | Centracare Clinic | Clinic/Center | 30 Railroad Ave, Albany, MN 56307 | 2015-12-01 |
| 1649447715 | Libby M Brever | Family Medicine | 30 Railroad Ave, Albany, MN 56307-9379 | 2008-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669023156 | Mary Jane Zeimetz | Technician | 355 Countryside Ln #6, Albany, MN 56307 | 2019-09-25 |
| 1003965047 | Harry J Larson | Dentist | 150 4th Street, Albany, MN 56307 | 2007-01-09 |
| 1952498214 | Katrina Coppicus | Occupational Therapist | 230 Church Street, Albany, MN 56307 | 2006-10-06 |
| 1104899939 | Mother of Mercy | Skilled Nursing Facility | 230 Church Avenue, Albany, MN 56307-0676 | 2006-02-10 |
| 1922302843 | Chi Health Connect At Home - Fargo | Hospice Care, Community Based | 131 8th Street South, Suite 1, Albany, MN 56307-0776 | 2011-01-06 |
| 1093019754 | Chi Health Connect At Home - Fargo | Home Health | 131 8th Street South, Suite 1, Albany, MN 56307-0776 | 2011-01-10 |
| 1427108273 | Robert C. Schwegler, Dds Pa | Clinic/Center | 421 Railroad Ave, Albany, MN 56307-0808 | 2007-01-12 |
| 1700408796 | Jessica Michael Lindquist | Counselor | 1185 Cranberry St, Albany, MN 56307-4518 | 2020-05-12 |
| 1417440223 | Megan Raiber | Dentist | 360 Railroad Ave, Albany, MN 56307-6201 | 2018-06-07 |
| 1730526419 | Leslie Marie Young | Counselor | 161 4th St Ste B, Albany, MN 56307-8356 | 2013-06-04 |
| Find all providers in zip 56307 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023619129 | Anna Leigh Vonck | Physician Assistant | 2 Executive Park Dr Ste 2, Albany, NY 12203-3700 | 2020-11-04 |
| 1407409113 | Morgan Shumway | Physician Assistant | 50 New Scotland Ave # Mc191, Albany, NY 12208-3403 | 2019-07-22 |
| 1588136279 | Christine Ciavarella | Physician Assistant | 405 Kains Ave Ste 205, Albany, CA 94706-1270 | 2018-12-19 |
| 1225503535 | Maura Kathleen Corbett | Physician Assistant | 43 New Scotland Ave Mc-139, Department of Emergency Medicine, Albany, NY 12208-3478 | 2018-10-12 |
| 1669966743 | Kimberly Aebli | Physician Assistant | 47 New Scotland Ave Mc 101, Albany, NY 12208 | 2018-06-21 |
| 1255844643 | Erica Francesca Lari Parks | Physician Assistant | 530 Kinkead Way Apt 205, Albany, CA 94706-2656 | 2017-11-08 |
| 1306376934 | Elisabeth Catherine Henderson | Physician Assistant | 98 Wolf Rd Ste 16, Albany, NY 12205-1226 | 2017-06-15 |
| 1417306374 | Larry James Edwards | Physician Assistant | 2030 Newton Rd, Albany, GA 31701-3520 | 2016-06-10 |
| 1477923019 | Cheyenne Allen Boone | Physician Assistant | 47 New Scotland Ave Mc-139, Albany Medical Center Dept Emergency Medicine, Albany, NY 12208-3412 | 2015-09-25 |
| 1396148300 | Tina Huang | Physician Assistant | 15 Norman Ave, Albany, NY 12203-5005 | 2014-10-03 |
| Find all providers in ALBANY | ||||
Please comment or provide details below to improve the information on JENNIFER NICOLE GANNON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.