Individual
CARLA FANELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
26 S BRYN MAWR AVE, BRYN MAWR, PA 19010-3201
(610) 527-3110
Mailing address
36 W MARTHART AVE, HAVERTOWN, PA 19083-2314
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP023871
PA
Other
Enumeration date
11/30/2021
Last updated
11/30/2021
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