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Individual

ANASTASSIA FENNEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
WHDNP

Contact information

Practice address
4881 SUGAR MAPLE DR, WPAFB, OH 45433-5529
(937) 257-1160
Mailing address
4881 SUGAR MAPLE DR, WPAFB, OH 45433-5529

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
9438714
FL
363LW0102X
Women's Health Nurse Practitioner
Primary
APRN11017263
FL

Other

Enumeration date
09/08/2018
Last updated
01/20/2022
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