Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jennifer Nicole Gannon, PA-C

Individual provider Athletic Trainer · NPI 1447308770

Jennifer Nicole Gannon, PA-C is a Physician Assistant in Sartell, Minnesota. Graduated from University of North Dakota School of Medicine in 2014, 12 years ago. Practices with Centracare Clinic, a 782-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Minnesota.

Years since qualifying
12
Trained at
University of North Dakota School of Medicine
Licensed in
MN
In the registry since
2007
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

101 Dehler Dr
Sartell, MN 56377-4407
Phone: (320) 845-2157
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 11639 (MN)
Athletic Trainer Taxonomy 2255A2300X · Licence 1881 (MN)
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1447308770
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJanuary 5, 2007
Last updated in NPPESApril 25, 2025
Certification dateApril 25, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolUNIVERSITY OF NORTH DAKOTA SCHOOL OF MEDICINE
Graduated 2014 (12 years in practice)
Group practice Centracare Clinic — 782 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations6 on file with Medicare

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