Individual
BRENNA FANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
435 S CRYSTAL ST STE 200, BUTTE, MT 59701-1506
(406) 496-3480
Mailing address
435 S CRYSTAL ST STE 200, BUTTE, MT 59701-1506
(406) 496-3480
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MED-PHYS-LIC-143760
MT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/19/2019
Last updated
08/22/2024
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