Individual
JON S. FANNIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
710 WATER ST, KERRVILLE, TX 78028-5329
(830) 896-1344
Mailing address
420 WATER ST, 105-B, KERRVILLE, TX 78028-5200
(830) 896-1344
(830) 896-1363
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R43299
NM
Other
Enumeration date
06/05/2006
Last updated
10/23/2007
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