Individual
MISS HALLIE RAE FANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM. D
Contact information
Practice address
522 N NEW BALLAS RD STE 206, SAINT LOUIS, MO 63141-6819
(314) 499-1227
(314) 499-1228
Mailing address
2260 HEPPERMAN RD, WENTZVILLE, MO 63385-5314
(573) 202-9152
(636) 278-4754
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
2018024631
MO
Other
Enumeration date
02/18/2019
Last updated
02/18/2019
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