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Organization

JCKM, LLC ABBE C FANNIN SOLE MBR

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ABBE C FANNIN CRNA (OWNER/PROVIDER)
(765) 284-0493
Entity
Organization

Contact information

Practice address
1416 GEORGE DIETER DR, EL PASO, TX 79936-7601
(915) 849-5104
Mailing address
PO BOX 41, MUNCIE, IN 47308-0041
(765) 284-0493
(765) 284-2434

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
647336
TX

Other

Enumeration date
07/16/2013
Last updated
08/26/2013
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