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Individual
KATHLEEN A GANNON
Active
Individual
KATHLEEN A GANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71007340A
IN
363L00000X
Nurse Practitioner
Primary
APRN11035733
FL
363LF0000X
Family Nurse Practitioner
APRN11035733
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125456200
—
FL
05
—
300009799
—
IN
Enumeration date
01/01/2018
Last updated
09/18/2026
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