Individual
BARBARA GANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
101 DUDLEY ST, PROVIDENCE, RI 02905-2401
(401) 274-1100
(401) 453-7948
Mailing address
18 MARTINS WAY, LINCOLN, RI 02865-1304
(401) 334-2407
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NPP25427
RI
363LN0000X
Neonatal Nurse Practitioner
NPP25427
RI
363LN0000X
Neonatal Nurse Practitioner
RN200043
MA
Other
Enumeration date
08/27/2010
Last updated
08/27/2010
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