Amy E Fannin (NPI# 1093124265, PAC ID# 7214159748) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1093124265 |
| PAC ID by PECOS | 7214159748 |
| Professional Enrollment ID | I20141117000979 |
| Full Name | Amy E Fannin |
| Organization Legal Name | AGNESIAN HEALTHCARE INC |
| Address |
608 W Brown St Waupun WI 53963-1702 |
| Phone Number | 9203246800 |
| Gender | F |
| Graduation Year | 2014 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 1658289624 |
| Number of Group Practice Members | 294 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 520088 | ST AGNES HOSPITAL |
| 521327 | WAUPUN MEMORIAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 420 E Division St, Fond Du Lac, WI 54935-4560 | AGNESIAN HEALTHCARE INC | |
| 430 E Division St, Fond Du Lac, WI 54935-4560 | 9209292300 | AGNESIAN HEALTHCARE INC |
| 608 W Brown St, Waupun, WI 53963-1702 | 9203246800 | AGNESIAN HEALTHCARE INC |
| 620 W Brown St, Waupun, WI 53963-1702 | AGNESIAN HEALTHCARE INC |
| Organization Legal Name | AGNESIAN HEALTHCARE INC |
| Physicians | 323 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Danielle Covach | Family Medicine | Agnesian Healthcare Inc | 835 Parkside St, Ripon, WI 54971-8505 |
| Kandipati Sreenivasarao | Family Medicine | Agnesian Healthcare Inc | 723 Parkridge Lane, North Fond Du Lac, WI 54937 |
| Matthew R Purcell | Anesthesiology | Agnesian Healthcare Inc | 430 E Divsion St, Fond Du Lac, WI 54935 |
| Suzanne T Mcgoey | Dermatology | Agnesian Healthcare Inc | 912 S Hickory St, Fond Du Lac, WI 54935-5530 |
| Robert M Bertram | Podiatry | Agnesian Healthcare Inc | 790 Eastgate Dr, Ripon, WI 54971-9614 |
| Shahriar Alizadegan | Vascular Surgery | Agnesian Healthcare Inc | 430 E Division St, Fond Du Lac, WI 54935-4560 |
| Bret N Pasiuk | Nephrology | Agnesian Healthcare Inc | 110 Monroe St, Beaver Dam, WI 53916-2437 |
| Jodi R Budwit | Nurse Practitioner | Agnesian Healthcare Inc | 10 Pluim Dr, Waupun, WI 53963-1564 |
| Bryan J Henslin | Chiropractic | Agnesian Healthcare Inc | 305 Camelot Dr, Fond Du Lac, WI 54935-8014 |
| Jeffrey A Strong | Family Medicine | Agnesian Healthcare Inc | 100 Evergreen Rd, Mt Calvary, WI 53057-9726 |
| Street Address |
608 W BROWN ST |
| City | WAUPUN |
| State | WI |
| Zip | 53963-1702 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Christopher C Tuveson | Urology | Agnesian Healthcare Inc | 608 W Brown St, Waupun, WI 53963-1702 |
| Karen E Reynolds | General Surgery | Agnesian Healthcare Inc | 608 W Brown St, Waupun, WI 53963-1702 |
| Christopher A Nervi | General Surgery | Agnesian Healthcare Inc | 608 W Brown St, Waupun, WI 53963-1702 |
| Eric R Nelson | Orthopedic Surgery | Agnesian Healthcare Inc | 608 W Brown St, Waupun, WI 53963-1702 |
| Sarika J Parikh Bertram | Podiatry | Agnesian Healthcare Inc | 608 W Brown St, Waupun, WI 53963-1702 |
| Manish Sharda | Family Medicine | Agnesian Healthcare Inc | 608 W Brown St, Waupun, WI 53963-1702 |
| Joel H Lundberg | Hematology/oncology | Agnesian Healthcare Inc | 608 W Brown St, Waupun, WI 53963-1702 |
| Philip J Mittelstaedt | Certified Registered Nurse Anesthetist (crna) | Agnesian Healthcare Inc | 608 W Brown St, Waupun, WI 53963-1702 |
| Peter W Timmermans | Family Medicine | Agnesian Healthcare Inc | 608 W Brown St, Waupun, WI 53963-1702 |
| Richard F Mcmahon Jr. | Family Medicine | Agnesian Healthcare Inc | 608 W Brown St, Waupun, WI 53963-1702 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mariano L Rosales Jr. | Internal Medicine | 600 Fern St, Waupun, WI 53963-1018 | |
| Michael J Vandecastle | Chiropractic | 16 N Madison St, Waupun, WI 53963-1129 | |
| Mitchell W Johnson | Chiropractic | 716 W Main St, Waupun, WI 53963-1230 | |
| Jodi R Budwit | Nurse Practitioner | Agnesian Healthcare Inc | 10 Pluim Dr, Waupun, WI 53963-1564 |
| Jennifer A Bara | Podiatry | Preferred Podiatry Group PC | 10 Pluim Dr, Waupun, WI 53963-1564 |
| Lifang Liu | Pathology | Fond Du Lac Pathology Consultants | 620 W Brown St, Waupun, WI 53963-1702 |
| Aaron H Thornton | Certified Registered Nurse Anesthetist (crna) | Agnesian Healthcare Inc | 620 W Brown St, Waupun, WI 53963-1702 |
| Anthony K Strigenz | Anesthesiology | Agnesian Healthcare Inc | 620 W Brown St, Waupun, WI 53963-1702 |
| Bradley J Hartmann | Diagnostic Radiology | Radiology Associates of The Fox Valley, Sc | 620 W Brown St, Waupun, WI 53963-1702 |
| John P Steinlage | Family Medicine | Ascension Medical Group-fox Valley Wisconsin, Inc | 620 W Brown St, Waupun, WI 53963-1702 |
| Find all physicians in zip 53963 | |||
| City | WAUPUN |
| Zip Code | 53963 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | WAUPUN + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Amy E Fannin.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.