Individual
ALICE J FANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
926 FRANCES DR, HAYNESVILLE, LA 71038-6100
(318) 624-0554
(318) 624-3782
Mailing address
926 FRANCES DR, HAYNESVILLE, LA 71038-6100
(318) 624-0554
(318) 624-3782
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
TAP002540
LA
Other
Enumeration date
06/02/2011
Last updated
06/02/2011
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