Individual
MS. KATHLEEN SUE FASNACHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
13000 BRUCE B DOWNS BLVD, TAMPA, FL 33604
(813) 972-2000
(813) 978-5968
Mailing address
8511 NORTH 29TH STREET, TAMPA, FL 33604-2206
(813) 841-5892
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
1633852
FL
Other
Enumeration date
10/03/2006
Last updated
07/08/2007
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