Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 30 days.

GANNON MITCHELL JAQUAY
NPI 1306767660
Student in an Organized Health Care Education/Training Program in Bear Lake, PA

Active since July 23, 2026
5763 ROUTE 958, BEAR LAKE, PA 16402(814) 779-1115 Get Directions Write a Review

NPPES record added: July 23, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Gannon Mitchell Jaquay NPPES

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

GANNON MITCHELL JAQUAY (NPI 1306767660) is an individual student in an organized health care education/training program in Bear Lake, Pennsylvania and active in the NPI registry since July 2026.

NPPES Registry Identity

NPI1306767660
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameGANNON MITCHELL JAQUAY
Location Address5763 ROUTE 958Bear Lake, PA 16402-2931
Mailing Address5763 Route 958Bear Lake, PA 16402-2931 · (814) 779-1115
Sole ProprietorYes
Enumeration DateJuly 23, 2026
NPPES CertifiedJuly 23, 2026
NPI 1306767660 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Taxonomy Code390200000X
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Also ListedSpecialist/Technologist · Athletic TrainerTaxonomy 2255A2300X
5763 ROUTE 958, Bear Lake, PA 16402

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 Gannon Jaquay's NPI number?

The NPI number for Gannon Jaquay is 1306767660. It was assigned to this individual provider in the NPPES registry on July 23, 2026.

Where is Gannon Jaquay located?

Gannon Jaquay practices at 5763 Route 958, Bear Lake, PA 16402. The listed phone number is (814) 779-1115.

What is Gannon Jaquay's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Gannon Jaquay was last updated on July 23, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.