Gannon, Nicole

Gannon, Nicole is an individual health care provider with primary practice located at 4500 San Pablo Rd S , Jacksonville FL 32224-1865. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Independent Medical Examiner, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Gannon, Nicole can be contacted via phone (904) 953-2000.

Contact Information

Primary practice address
4500 San Pablo Rd S Jacksonville FL 32224-1865
Phone: (904) 953-2000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Independent Medical Examiner 202C00000X PA9107493 Florida
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA9107493 Florida

Profile Details

NPI number 1467881615
LBN Legal business name Gannon, Nicole
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 8th, 2013
Last updated Jan 22nd, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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