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Individual

MS. LINDSEY FANCETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
3075 GOVERNORS PLACE BLVD, SUITE 120, DAYTON, OH 45409-1323
(193) 742-4258
Mailing address
134 E 2ND ST, SPRINGFIELD, OH 45504-1449

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.004657RX
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1316923915
ORGANIZATION
OH
Enumeration date
10/03/2016
Last updated
10/03/2016
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