Individual
GENETTA ANN FANCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N. P.
Contact information
Practice address
307 S INDIANA AVE, ENGLISH, IN 47118
(812) 338-2924
(812) 338-3706
Mailing address
420 W LONGEST ST, PO BOX 270, PAOLI, IN 47454-8821
(812) 723-7993
(812) 723-7991
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71001020A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200322140A
—
IN
Enumeration date
09/05/2006
Last updated
06/20/2011
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