Individual
LESLIE FANNIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
613 23RD ST STE 340, ASHLAND, KY 41101-2879
(606) 329-2888
Mailing address
PO BOX 2379, ASHLAND, KY 41105-2379
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4047191
KY
Other
Enumeration date
10/02/2025
Last updated
12/22/2025
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