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Individual

LINDSEY BRYANT FANNIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1265 HIGHWAY 54 STE 500C, FAYETTEVILLE, GA 30214-4537
(678) 435-3040
Mailing address
1050 BRITTANY WAY, FAYETTEVILLE, GA 30214-4782
(205) 243-7828

Taxonomy

Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
RN250418
GA
207RI0200X
Infectious Disease Physician
Primary
RN250418
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
RN250418
REGISTERED NURSE LICENSE
GA
Enumeration date
09/11/2021
Last updated
09/11/2021
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