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Individual

JAMIE FANNIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, ACSM-CEP

Contact information

Practice address
135 E MAXWELL ST STE 103, LEXINGTON, KY 40508-2621
(859) 323-5424
Mailing address
135 E MAXWELL ST STE 103, LEXINGTON, KY 40508-2621

Taxonomy

Speciality
Code
Description
License number
State
224Y00000X
Clinical Exercise Physiologist
Primary
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1065850
KY
05
429776
KY
Enumeration date
03/25/2022
Last updated
03/25/2022
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