National Provider Identifier
Nicole R Gannon, ANP
Nicole R Gannon, ANP is listed in the NPPES registry with a primary specialty of Adult Health Nurse Practitioner in Orchard Park, NY and a listed phone number of (716) 712-7555.
Profile Overview
- NPI
- 1689947426
- Provider Type
- Individual
- Primary Specialty
- Adult Health Nurse Practitioner
- Enumeration Date
- February 09, 2012
- Last Updated
- October 10, 2024
Practice Location
- 3685 Southwestern Blvd
- Orchard Park, NY 14127-1732
Phone: (716) 712-7555
Specialties
- Adult Health Nurse Practitioner (363LA2200X)
- Adult Health Nurse Practitioner (363LA2200X)
- Nurse Practitioner (363L00000X)
Full Record
- NPI
- 1689947426
- Entity Type
- Individual
- Last Name
- Gannon
- First Name
- Nicole
- Middle Name
- R
- Credential
- ANP
- Mailing Street Address
- 3685 Southwestern Blvd
- Mailing City
- Orchard Park
- Mailing State
- NY
- Mailing ZIP Code
- 14127-1732
- Mailing Country
- US
- Mailing Phone
- (716) 712-7555
- Practice Street Address
- 3685 Southwestern Blvd
- Practice City
- Orchard Park
- Practice State
- NY
- Practice ZIP Code
- 14127-1732
- Practice Country
- US
- Practice Phone
- (716) 712-7555
- Enumeration Date
- February 09, 2012
- Last Updated
- October 10, 2024
- Sex
- Female
- Sole Proprietor
- Yes
- Certification Date
- October 10, 2024
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Adult Health Nurse Practitioner (363LA2200X), Adult Health Nurse Practitioner (363LA2200X), Nurse Practitioner (363L00000X)