Individual
PAULA GANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
21 MUNICIPAL DR, ARNOLD, MO 63010-1012
(636) 296-6206
(636) 296-0102
Mailing address
227 E MAIN ST, FESTUS, MO 63028-1952
(636) 931-2700
(636) 931-5304
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2007029761
MO
Other
Enumeration date
03/26/2015
Last updated
03/26/2015
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