MEDICARE: BARBARA K FANE RN MSN ANP ADCN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2100X	Acute Care Nurse Practitioner	F303203	NY

General Provider Information

NPI Number	:	1861486383
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA K FANE RN MSN ANP ADCN

Provider Business Mailing Address
First Line	:	7 SOUTHWOODS BLVD
Second Line	:	CAPITAL CARDIOLOGY ASSOCIATES PC
City	:	ALBANY
State	:	NY
Zip	:	12211-2526
Country	:	US
Telephone Number	:	518-292-6000
Fax Number	:	518-641-6766

Provider Business Practice Location Address
First Line	:	2231 BURDETT AVE
Second Line	:	STE 160
City	:	TROY
State	:	NY
Zip	:	12180-2447
Country	:	US
Telephone Number	:	518-292-6200
Fax Number	:	518-292-6228

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/12/2005
Last Update Date	:	07/08/2007

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