JCKM, LLC Abbe C Fannin Sole MBR

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

647336 Issued in TX

Legal business name

JCKM, LLC ABBE C FANNIN SOLE MBR

Practice address

1416 George Dieter Dr
El Paso, TX 79936-7601

Phone

(915) 849-5104

NPI assigned

Jul 16, 2013

Last updated

Aug 26, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Abbe C Fannin, CRNANPI 1194723940

Title

Owner/Provider

Phone

(765) 284-0493

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Abbe C Fannin, CRNA

  • Certified Registered Nurse Anesthetist
  • El Paso, TX
  • NPI 1194723940
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1373932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377475200000",
    "number": "1205277456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 41",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473080041",
            "telephone_number": "765-284-0493",
            "fax_number": "765-284-2434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1416 GEORGE DIETER DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799367601",
            "telephone_number": "915-849-5104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JCKM, LLC ABBE C FANNIN SOLE MBR",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-16",
        "last_updated": "2013-08-26",
        "status": "A",
        "authorized_official_last_name": "FANNIN",
        "authorized_official_first_name": "ABBE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "765-284-0493",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "647336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jax0N Mak & Associates, Inc
• Jaxon Mak & Associates Inc
• Julianna Marie Jayne, R.D.
• Jazlex Inc
• JB Kids Therapy LLC
• JCL Construction
• JCS Medical Transportation LLC
• JDMD Clinics, P. a. (El Paso Advanced Pain Institute)
• Imelda Lucia Jean
• Jeanette Tan, MD, PA

• Certified Registered Nurse Anesthetist in El Paso, TX
• Providers in El Paso, TX by specialty
• Certified Registered Nurse Anesthetist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.