Individual
NICOLE RENEE FANELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3400 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-5127
(215) 349-8310
(215) 662-2739
Mailing address
3400 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-5127
(215) 349-8310
(215) 662-2739
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN584593
PA
Other
Enumeration date
10/17/2014
Last updated
10/31/2019
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