Individual
DEANNA FANNING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1318 WAYNE ST, MT PLEASANT, SC 29464-4423
(843) 906-1493
Mailing address
1318 WAYNE ST, MT PLEASANT, SC 29464-4423
(843) 906-1493
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
37900
SC
Other
Enumeration date
03/09/2021
Last updated
03/09/2021
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