Individual
PATRICIA GANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPH, CNP
Contact information
Practice address
17578 DODD BLVD, LAKEVILLE, MN 55044-3909
(952) 484-8060
Mailing address
17578 DODD BLVD, LAKEVILLE, MN 55044-3909
(952) 484-8060
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R 79950-2
MN
Other
Enumeration date
07/25/2012
Last updated
07/25/2012
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