Jacklyn Gannon
Jacklyn Gannon is a Nurse Practitioner in Stony Brook, New York. Qualified in 2023, 3 years ago. Practices with Psychiatric Nurse Practitioner PC, a 42-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New York.
- Years since qualifying
- 3
- Licensed in
- NY
- In the registry since
- 2023
- Specialties on file
- 2
Practice location Address checks out
101 Nicolls RdStony Brook, NY 11794-0001
Phone: (631) 638-1036
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Psychiatric/Mental Health Nurse Practitioner (primary) | Taxonomy 363LP0808X · Licence 405347 (NY) |
|---|---|
| Emergency Registered Nurse | Taxonomy 163WE0003X · Licence 745153 (NY) |
Record details
| NPI number | 1841078359 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | Yes |
| NPI enumerated | September 18, 2023 |
| Last updated in NPPES | October 10, 2023 |
| Certification date | October 10, 2023 |
| Mailing address | 55c Commodore Ln, West Babylon, NY 11704-8203 |
Medicare enrollment
| Medicare specialty | NURSE PRACTITIONER |
|---|---|
| Medical school | OTHER |
| Graduated | 2023 (3 years in practice) |
| Group practice | Psychiatric Nurse Practitioner Pc — 42 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Telehealth | Offers telehealth services |
Other providers in Stony Brook
-
Madeleine Amelia Gondek-Brown
101 Nicolls Rd, Stony Brook, NY 11794-0001 · (203) 240-3101
-
William Gary Leverton II, NP
Hsc T12 Rm 080 NY Spine And Brain Surgery, Stony Brook, NY 11794-0001 · (631) 444-1116