DAJUAN FANNING NPI 1376102434

NPI Information

  • NPI: 1376102434
  • Provider Name: DAJUAN FANNING
  • Classification: Licensed Practical Nurse - 164W00000X
  • Entity Type: Individual
  • Address: 17072 NEW HAMPSHIRE DR
    SOUTHFIELD, MI
    ZIP 48075
  • Phone: (313) 213-7470

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NPI Details

Dajuan Fanning is a licensed practical nurse in Southfield, MI. The provider is a licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. Dajuan Fanning NPI is 1376102434. 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:

17072 NEW HAMPSHIRE DR
SOUTHFIELD, MI
ZIP 48075-972
Phone: (313) 213-7470

The enumeration date for this NPI number is 6/11/2019 and was last updated on 6/11/2019.

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
1372500000XChore ProviderNo
2374U00000XHome Health AideNo
3405300000XPrevention Professional4703116420MICHIGANNo
4164W00000XLicensed Practical Nurse4703116420MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
14703116420OTHERMICHIGANBCBS
24703116420MEDICAIDMICHIGAN

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: 11/21/2025

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