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Individual

ISMAEL D FANNY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPN

Contact information

Practice address
116 BAY VW, MADISON, WI 53715-1402
(608) 255-1914
(413) 383-1691
Mailing address
18 RIDGEVIEW CT APT 5, MADISON, WI 53704-4383
(608) 301-7527

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
260333-30
WI

Other

Enumeration date
11/29/2006
Last updated
08/23/2024
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