MS. CONNIE SUE GANNON NP NPI 1104869742

NPI Information

NPI: 1104869742
Provider Name: MS. CONNIE SUE GANNON, NP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
233 HURST ST
CENTER, TX
ZIP 75935
Phone: (936) 591-8171
Get Directions

MS. Connie Sue Gannon, NP is a family nurse practitioner in Center, TX. MS. Connie Sue Gannon, NP NPI is 1104869742. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

233 HURST ST
CENTER, TX
ZIP 75935-321
Phone: (936) 591-8171
Fax: (936) 591-8176

The NPI 1104869742 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/13/2006 and was last updated on 7/10/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	APO3124	LOUISIANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	S54637	MEDICARE UPIN	LOUISIANA
2	1538388	MEDICAID	LOUISIANA
3	3B995DQ44	MEDICARE PIN	LOUISIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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