| Doctor Name: | AMY M. GANNON |
| NPI Number: | 1962743773 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RDLD |
| License Number: | |
| Business Practice Address: | 600 Tracy Way Charleston, WV - 253111262 |
| Business Phone Number: | 3043884965 |
| Business Fax Number: | 3043434850 |
| Mailing Address: | 415 Morris St, Suite 304 CHARLESTON |
| State: | WV |
| Postal Code: | 253011842 |
| Phone Number: | 3043887782 |
| Fax Number: | 3043887788 |
| NPI Enumeration Date: | 03/05/2013 |
| NPI Last Update Date: | 03/05/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WV |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |