Individual
MRS. KIMBERLY R FANNIN - TRISLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2106 LOOP RD # C, WINNSBORO, LA 71295-3344
(318) 435-4571
(318) 435-3842
Mailing address
1154 LOGAN SEWELL DR, VIDALIA, LA 71373-3342
(318) 336-8166
(318) 336-8169
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
085994
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447498
—
LA
Enumeration date
09/21/2006
Last updated
03/19/2015
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