Provider Demographics
NPI:1457180622
Name:FANTER, ERIN RENEE (LPN)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:RENEE
Last Name:FANTER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1425 SW SUMMIT WOODS DR APT 2
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66615-1466
Mailing Address - Country:US
Mailing Address - Phone:620-617-6055
Mailing Address - Fax:
Practice Address - Street 1:8030 REEDER ST
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66214-1554
Practice Address - Country:US
Practice Address - Phone:800-346-6711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS23-27513-071164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse