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CAMILLE GANNON
NPI 1003644428
Physician Assistant in Longmont, CO

Active since July 25, 2024
2017 100 YEARPARTY CT # 80504, LONGMONT, CO 80504(303) 848-3800 Get Directions Write a Review

NPPES record last updated: April 2, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 2, 2026, Jul 25, 2024 (2 updates tracked since 2024).

About Camille Gannon NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CAMILLE GANNON (NPI 1003644428) is an individual physician assistant in Longmont, Colorado and active in the NPI registry since July 2024. She maintains a secondary practice location in Boulder.

NPPES Registry Identity

NPI1003644428
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameCAMILLE GANNON
Location Address2017 100 YEARPARTY CT # 80504Longmont, CO 80504-8475
Mailing Address220 Wright St Apt 203Lakewood, CO 80228-1409 · (715) 781-0949
Phone(303) 848-3800
Sole ProprietorNo
Enumeration DateJuly 25, 2024
Last NPPES UpdateApril 2, 20262 updates tracked since enumeration
NPPES CertifiedApril 2, 2026
✔ NPI 1003644428 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
2017 100 YEARPARTY CT # 80504, Longmont, CO 80504
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Secondary Practice Location 1

Location 13601 Arapahoe Ave Unit D176Boulder, CO 80303-1310 · Phone (303) 848-3800

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Camille Gannon's NPI number?

The NPI number for Camille Gannon is 1003644428. It was assigned to this individual provider in the NPPES registry on July 25, 2024.

Where is Camille Gannon located?

Camille Gannon practices at 2017 100 Yearparty Ct # 80504, Longmont, CO 80504. The listed phone number is (303) 848-3800.

What is Camille Gannon's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Camille Gannon was last updated on April 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.