Individual
MISS MARY THERESA FANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
2350 FREEDOM WAY STE 200, YORK, PA 17402-8200
(717) 812-5120
Mailing address
19 CIRCLE DR, GLEN ROCK, PA 17327-1341
(717) 701-6046
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP018724
PA
Other
Enumeration date
06/15/2018
Last updated
01/24/2020
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