Provider Demographics
NPI:1497509491
Name:GANON, CLAIRE BAYONA (RN, GERO-BC)
Entity type:Individual
Prefix:MRS
First Name:CLAIRE
Middle Name:BAYONA
Last Name:GANON
Suffix:
Gender:F
Credentials:RN, GERO-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 ROUTE 8 STE 303
Mailing Address - Street 2:
Mailing Address - City:MAITE
Mailing Address - State:GU
Mailing Address - Zip Code:96910-2003
Mailing Address - Country:US
Mailing Address - Phone:671-687-1320
Mailing Address - Fax:
Practice Address - Street 1:400 ROUTE 8
Practice Address - Street 2:
Practice Address - City:MAITE
Practice Address - State:GU
Practice Address - Zip Code:96910-2027
Practice Address - Country:US
Practice Address - Phone:671-475-0061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-16
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GURX0539163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse