Individual provider · Type 1 NPI
Mary Fannon
Acute Care Nurse Practitioner · Philadelphia, PA
NPI number
1043933518
Active
Practice location
111 S 11th St
Philadelphia, PA 19107-4824
Mailing address
2437 Ardsley Ave
Glenside, PA 19038-3701
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Acute Care Nurse Practitioner Primary | 363LA2100X | SP026285 (PA) |
Acute Care Nurse Practitioner: Definition to come...
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About NPI 1043933518
Mary Fannon's National Provider Identifier is 1043933518, issued on Sep 20, 2022. The primary taxonomy on file is Acute Care Nurse Practitioner (363LA2100X), and the practice location is in Philadelphia, PA. The record was last updated on Sep 20, 2022.