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Individual
MRS. KATIE FANT
Active
Individual
MRS. KATIE FANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
121478
AK
163W00000X
Registered Nurse
Primary
204996
AZ
163W00000X
Registered Nurse
420416
OH
163W00000X
Registered Nurse
9443691
FL
Other
Enumeration date
05/12/2017
Last updated
05/12/2017
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