Individual
MRS. JENNIFER DIANE FANELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3330 W 4000 S APT G205, WEST HAVEN, UT 84401-9543
(541) 604-6875
Mailing address
3330 W 4000 S APT G205, WEST HAVEN, UT 84401-9543
(541) 604-6875
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
12950044
UT
Other
Enumeration date
08/11/2022
Last updated
08/11/2022
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