Individual
DEANA KAY FANELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
335 GLESSNER AVE, MANSFIELD, OH 44903-2269
(419) 756-8899
Mailing address
PO BOX 7527, DUBLIN, OH 43017-0727
(614) 544-6356
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
COA.11614-NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3084942
—
OH
Enumeration date
01/26/2007
Last updated
01/25/2022
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