Individual
ANDREA N MCGANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2100 SE SALERNO RD, STUART, FL 34997-6503
(772) 781-2735
(772) 781-2739
Mailing address
3634 NW ADRIATIC LN, JENSEN BEACH, FL 34957-3111
(440) 391-7017
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9116067
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/25/2020
Last updated
09/27/2023
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