Individual provider · Type 1 NPI

Mariah Stacy Gann, PA-C

Medical Physician Assistant · Columbia, MO

NPI number 1851077408 Active

Practice location

525 N Keene St Ste 301
Columbia, MO 65201-8106

Call (573) 449-2141 Map

Fax (573) 556-1750

Mailing address

1241 W Stadium Blvd
Jefferson City, MO 65109-6023

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program 390200000XNone listed
Medical Physician Assistant Primary 363AM0700XNone listed

Medical Physician Assistant: Definition to come...

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About NPI 1851077408

Mariah Stacy Gann, PA-C's National Provider Identifier is 1851077408, issued on Jun 27, 2023. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Columbia, MO. The record was last updated on Aug 20, 2025.