Individual
KEITH RAY FANNIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
ONE MEDICAL CENTER DRIVE, DARTMOUTH HITCHCOCK - GENERAL SURGERY, LEBANON, NH 03756
(603) 650-7903
Mailing address
ONE MEDICAL CENTER DRIVE, DARTMOUTH HITCHCOCK - GENERAL SURGERY, LEBANON, NH 03756
(603) 650-7903
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
RN.372827
OH
363L00000X
Nurse Practitioner
077205-23
NH
363LF0000X
Family Nurse Practitioner
Primary
077205-23
NH
Other
Enumeration date
09/14/2016
Last updated
03/20/2018
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