Individual
FANTA C SACCOH
Active
Individual
FANTA C SACCOH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L2-0009395
DE
363LF0000X
Family Nurse Practitioner
Primary
LG-0013810
DE
Other
Enumeration date
05/30/2007
Last updated
05/01/2026
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up