Individual
SAMANTHA MADISON MCGANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
10201 DOUBLE R BLVD STE 315, RENO, NV 89521-6091
(775) 982-3443
(775) 982-3441
Mailing address
1155 MILL ST, MS M-14, RENO, NV 89502-1576
(775) 982-5262
(775) 982-3441
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA3087
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16328317
CAQH
NV
01
—
PA3087
LICENSE
NV
Enumeration date
05/16/2023
Last updated
05/19/2026
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