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General NPI Number Information
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NPI Number | 1609726660
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Entity Type | Organization
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Legal Business Name | FANN FAMILY MEDICINE
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Dates
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Enumeration Date | 01/30/2026
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Last Update Date | 01/30/2026
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Provider Practice Location Address
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Address Line | 211 W CUMBERLAND ST
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City | DUNN
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State | NC
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Zip | 28334-4815
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Country | US
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Telephone | 910-214-6792
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Fax |
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Provider Business Mailing Address
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Address Line | 1145 MCPHAIL RD
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City | ROSEBORO
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State | NC
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Zip | 28382-7066
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Country | US
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Telephone | 910-214-6792
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Fax |
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Authorized Official
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Title or Position | OWNER/ NURSE PRACTITIONER
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Name | AUSTIN FANN
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Credential | FNP-C
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Telephone | 910-214-6792
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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