Most Relevant Information
Provider Data
| NPI Number: | 1003200130 |
| Provider Name: | PAULA GANNON |
| Entity Type: | Individual |
| Taxonomy Code: | 163W00000X |
| Specialty: | Registered Nurse |
| License Number: | 2007029761 |
Most Important Dates
| Enumeration Date: | 03/26/2015 |
| Last Updated: | 03/26/2015 |
Provider Practice Location
21 MUNICIPAL DR
ARNOLD
MO
630101012
Practice Location Phone/Fax
| Phone: | 6362966206 |
| Fax: | 6362960102 |
Provider Mailing Location
227 E MAIN ST
FESTUS
MO
630281952
Provider Mailing Phone/Fax
| Phone: | 6369312700 |
| Fax: | 6369315304 |