Individual
ERIN FANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1450 CHAPEL ST, NEW HAVEN, CT 06511-4405
(203) 789-3351
Mailing address
996 MAIN ST APT 216, BRANFORD, CT 06405-7708
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
129872
CT
367500000X
Certified Registered Nurse Anesthetist
Primary
080854-23
NH
367500000X
Certified Registered Nurse Anesthetist
7971
CT
367500000X
Certified Registered Nurse Anesthetist
RN2342913
MA
Other
Enumeration date
10/15/2018
Last updated
02/02/2023
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