LEWIS DALE FANNON RN NP NPI 1063845832

NPI Information

NPI: 1063845832
Provider Name: LEWIS DALE FANNON, RN, NP
Classification: Nurse Practitioner - 363LA2200X
Entity Type: Individual

Specialization: Adult Health

PECOS Registration: Yes

Address:
50 SHRADER ST
SAN FRANCISCO, CA
ZIP 94117
Phone: (415) 668-4166
Get Directions

Lewis Dale Fannon, RN, NP is an adult health nurse practitioner in San Francisco, CA. Lewis Dale Fannon, RN, NP NPI is 1063845832. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

50 SHRADER ST
SAN FRANCISCO, CA
ZIP 94117-015
Phone: (415) 668-4166

The NPI 1063845832 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 8/15/2013 and was last updated on 1/29/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163W00000X	Registered Nurse		801999	CALIFORNIA	No
2	363LA2200X	Nurse Practitioner	Adult Health	23521	CALIFORNIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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