Individual
CORRI LEEANN FANCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
4023 SHENANDALE ST, SAN ANTONIO, TX 78230-1639
(210) 740-8678
Mailing address
4023 SHENANDALE ST, SAN ANTONIO, TX 78230-1639
(210) 740-8678
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1048917
TX
Other
Enumeration date
08/24/2021
Last updated
08/24/2021
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