Fannin, Alice A
Fannin, Alice A is an individual health care provider with primary practice located at 630 Plantation St , Worcester MA 01605. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Fannin, Alice A can be contacted via phone (508) 595-2000.Contact Information
Primary practice address
630 Plantation St
Worcester MA 01605
Phone: (508) 595-2000
Fax: (508) 853-7149
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 1422 | Massachusetts |
Profile Details
| NPI number | 1649240896 |
|---|---|
| LBN Legal business name | Fannin, Alice A |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 23rd, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1649240896 | NPPES |
| Other | 970024208 | RAILROAD MEDICARE | |
| Other | 042472266 | RAILROAD MEDICARE | |
| Other | 8301088 | RAILROAD MEDICARE | |
| Other | 53324 | RAILROAD MEDICARE | |
| Other | AP1638 | RAILROAD MEDICARE |
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