Individual
MARJORIE ANN FANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1001 JOHNSON FERRY RD NE, ATLANTA, GA 30342-1605
(404) 785-2273
Mailing address
5183 INDIAN CIR, GAINESVILLE, GA 30506-3173
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN048537 NP
GA
Other
Enumeration date
07/28/2006
Last updated
07/08/2007
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