Provider Demographics
NPI:1275781312
Name:ENDRES, FANNIE G (RN)
Entity Type:Individual
Prefix:
First Name:FANNIE
Middle Name:G
Last Name:ENDRES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11436 US HIGHWAY 42
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:KY
Mailing Address - Zip Code:41091-9483
Mailing Address - Country:US
Mailing Address - Phone:859-384-2927
Mailing Address - Fax:859-384-2927
Practice Address - Street 1:11436 US HIGHWAY 42
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:KY
Practice Address - Zip Code:41091-9483
Practice Address - Country:US
Practice Address - Phone:859-384-2927
Practice Address - Fax:859-384-2927
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-03
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1038709163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management