Individual
MS. STEPHANIE DIANE FANNIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, BSN, CCM
Contact information
Practice address
3191 MEDICAL CENTER DR APT 14106, MCKINNEY, TX 75069-1679
(214) 799-9684
Mailing address
3191 MEDICAL CENTER DR APT 14106, MCKINNEY, TX 75069-1679
(214) 799-9684
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
669441
TX
Other
Enumeration date
05/18/2018
Last updated
05/18/2018
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