Fanning, Stephanie
Fanning, Stephanie is an sole proprietor health care provider with primary practice located at 3211 Monte Vista Blvd Ne , Albuquerque NM 87106-2119. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist is her primary health care specialty. Fanning, Stephanie can be contacted via phone (505) 268-3520.Contact Information
Primary practice address
3211 Monte Vista Blvd Ne
Albuquerque NM 87106-2119
Phone: (505) 268-3520
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist | 225700000X | 2632 | New Mexico |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist | 225X00000X | 1943 | New Mexico |
Profile Details
| NPI number | 1205996857 |
|---|---|
| LBN Legal business name | Fanning, Stephanie |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 12th, 2006 |
| Last updated | Jul 9th, 2007 - about 18 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 | 1205996857 | NPPES |
| New Mexico | MEDICAID | 26903318 |
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