Individual
ANNA ELISE FENTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
6210 S BROADWAY AVE, TYLER, TX 75703-4413
(903) 579-2700
(903) 579-2799
Mailing address
6210 S BROADWAY AVE, TYLER, TX 75703-4413
(903) 579-2700
(903) 579-2799
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1055530
TX
Other
Enumeration date
09/29/2021
Last updated
09/29/2021
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