Fanning, Dajuan

Fanning, Dajuan is an individual health care provider with primary practice located at 17072 New Hampshire Dr , Southfield MI 48075-2972. He recently has 4 registered licenses in different health care specialties including Nursing Service Related Providers / Chore Provider, Nursing Service Related Providers / Home Health Aide, Other Service Providers / Prevention Professional, Nursing Service Providers / Licensed Practical Nurse. Nursing Service Providers / Licensed Practical Nurse is his primary health care specialty. Fanning, Dajuan can be contacted via phone (313) 213-7470.

Contact Information

Primary practice address
17072 New Hampshire Dr Southfield MI 48075-2972
Phone: (313) 213-7470
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Related Providers / Chore Provider 372500000X
Nursing Service Related Providers / Home Health Aide 374U00000X
Other Service Providers / Prevention Professional 405300000X 4703116420 Michigan
Nursing Service Providers / Licensed Practical Nurse 164W00000X 4703116420 Michigan

Profile Details

NPI number 1376102434
LBN Legal business name Fanning, Dajuan
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 11th, 2019
Last updated Jun 11th, 2019 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376102434 NPPES
Michigan MEDICAID 4703116420
Michigan Other 4703116420

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