Individual
PATRICIA ANN FAHEY-BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
121 DREW AVE SE, MADELIA, MN 56062-1841
(507) 642-5200
(507) 642-5203
Mailing address
121 DREW AVE SE, MADELIA, MN 56062-1841
(507) 642-5200
(507) 642-5203
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R1179338
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
347040700
—
MN
Enumeration date
06/04/2006
Last updated
07/22/2020
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