Individual
MS. LARA KARINA GANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1101 VETERANS DRIVE, VA MEDICAL CENTER, LEXINGTON, KY 40502-2236
(859) 324-5941
Mailing address
103 PATRICK HENRY CT, DANVILLE, KY 40422-1788
(859) 324-5941
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
KY
Other
Enumeration date
05/10/2006
Last updated
08/15/2013
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