Individual
AUDREY A FANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
223 MAIN ST, BEACON, NY 12508-2770
(845) 838-4900
(845) 838-4915
Mailing address
223 MAIN ST, BEACON, NY 12508-2770
(845) 838-4900
(845) 838-4915
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
379153
NY
Other
Enumeration date
09/20/2012
Last updated
09/20/2012
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