Provider Demographics
NPI:1598744989
Name:FANCHER, RONALD ALBERT (FNP/CNM)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:ALBERT
Last Name:FANCHER
Suffix:
Gender:M
Credentials:FNP/CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4650 TAYLOR RD BLDG 17A
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20889-5638
Mailing Address - Country:US
Mailing Address - Phone:301-400-0894
Mailing Address - Fax:
Practice Address - Street 1:4650 TAYLOR RD BLDG 17A
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-5638
Practice Address - Country:US
Practice Address - Phone:301-400-0894
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-13
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3265752367A00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife