Individual
LOGAN ELIZABETH FANNIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
21 KENWOOD ST, GREENFIELD, MA 01301-1973
(413) 223-5265
Mailing address
417 LIBERTY ST, SPRINGFIELD, MA 01104-3736
(413) 747-0705
(413) 732-7075
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN2310050
MA
Other
Enumeration date
06/21/2024
Last updated
06/21/2024
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