Individual
MRS. ALICIA BROOKE FANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1905 N JACKSON ST, TULLAHOMA, TN 37388-2200
(931) 461-1300
Mailing address
1905 N JACKSON ST, TULLAHOMA, TN 37388-2200
(931) 461-1300
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
179294
TN
Other
Enumeration date
06/29/2017
Last updated
03/17/2018
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