Provider Demographics
NPI:1649945940
Name:GANNON, ANIKA COLE (CNM, DNP, ARNP)
Entity type:Individual
Prefix:
First Name:ANIKA
Middle Name:COLE
Last Name:GANNON
Suffix:
Gender:F
Credentials:CNM, DNP, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5127
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98206-5127
Mailing Address - Country:US
Mailing Address - Phone:206-860-5414
Mailing Address - Fax:206-720-8462
Practice Address - Street 1:900 PACIFIC AVE FL 5
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-4168
Practice Address - Country:US
Practice Address - Phone:425-339-5430
Practice Address - Fax:425-339-5454
Is Sole Proprietor?:No
Enumeration Date:2021-08-10
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60867666163WW0101X
WAAP61169082367A00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife