Provider Demographics
NPI:1508038340
Name:FANJOY, SUNNY JEAN (HHA)
Entity Type:Individual
Prefix:MRS
First Name:SUNNY
Middle Name:JEAN
Last Name:FANJOY
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 WICK AVE
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44805-1509
Mailing Address - Country:US
Mailing Address - Phone:419-496-1039
Mailing Address - Fax:
Practice Address - Street 1:809 WICK AVE
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OH
Practice Address - Zip Code:44805-1509
Practice Address - Country:US
Practice Address - Phone:419-496-1039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-01
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2721648Medicaid