Individual
KAITLYN GANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
555 E CHEVES ST, FLORENCE, SC 29506-2617
(843) 777-2000
Mailing address
555 E CHEVES ST, FLORENCE, SC 29506-2617
(843) 777-2000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5965
SC
Other
Enumeration date
09/11/2025
Last updated
09/11/2025
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