Mrs. Holly E Gannon
Nurse Practitioner - Critical Care Medicine
1465 S Grand Blvd
Saint Louis
, Missouri 63104-1003
Mrs. Holly E Gannon
Nurse Practitioner - Critical Care Medicine
1465 S Grand Blvd
Saint Louis
, Missouri 63104-1003
(636) 922-9446
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About
Features
Specialties
- Nurse Practitioner - Critical Care Medicine
Languages spoken
- English
Location
First Address
- Mrs. Holly E Gannon
- 2 Auburn Ridge Ct
- Saint Peters, MO
- Zip : 63376-6865
- Phone : (636) 922-9446
Second Address
- Mrs. Holly E Gannon
- 1465 S Grand Blvd
- Saint Louis, MO
- Zip : 63104-1003
- Fax : (314) 268-6474
- Phone : (314) 268-2700
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 106839 | MO |
National Provider Identifier
| NPI | 1396960951 |
|---|---|
| Provider Name | Mrs. Holly E Gannon |
| First Address | Saint Peters, MO 63376-6865 |
| Second Address | Saint Louis, MO 63104-1003 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 16/04/2007 |
| Last Update Date | 19/11/2020 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.