Individual provider · Type 1 NPI

Jennifer S. Gannon, PA

Surgical Physician Assistant · Frederick, MD

NPI number 1396703575 Active

Practice location

501 W 7th St
Frederick, MD 21701-4586

Call (301) 663-9573 Map

Mailing address

PO Box 37086
Baltimore, MD 21297-3086

Other practice locations

  • 52 Thomas Johnson Dr, Frederick, MD 21702-4300 · (301) 663-9573

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant 363AM0700XC0002836 (MD)
Surgical Physician Assistant Primary 363AS0400XC0002836 (MD)

Surgical Physician Assistant: Definition to come...

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About NPI 1396703575

Jennifer S. Gannon, PA's National Provider Identifier is 1396703575, issued on May 3, 2006. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Frederick, MD. The record was last updated on Jan 24, 2020.