| Doctor Name: | MRS. MARYANN FANNING |
| NPI Number: | 1225449226 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CNP |
| License Number: | CP000853 |
| Business Practice Address: | 33 3rd St Se Ste 201 Huron, SD - 573502064 |
| Business Phone Number: | 6055540858 |
| Business Fax Number: | 6056104063 |
| Mailing Address: | 23805 290th St, TUTHILL |
| State: | SD |
| Postal Code: | 575746112 |
| Phone Number: | 6056856878 |
| Fax Number: | 6056856878 |
| NPI Enumeration Date: | 05/13/2014 |
| NPI Last Update Date: | 05/13/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | CP000853 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SD |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |