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1093124265
AMY E FANNIN
FOND DU LAC, WI
NPI
1093124265
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LA2200X Nurse Practitioner, Adult Health
(Licence: WI 5904-33)
Enumeration Date
2014-08-12
Last Update Date
2020-12-21
Business Address
AMY E FANNIN APNP
430 E DIVISION ST
FOND DU LAC, WI 54935-4560
Phone number: 920-926-4530
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Mailing Address
AMY E FANNIN APNP
420 E DIVISION ST
FOND DU LAC, WI 54935-4560
Phone number: 920-926-8340
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