Fanny Mak, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

12104 Issued in TN

Practice address

1101 Market St
BR-3D
Chattanooga, TN 37402-2881

Phone

(423) 751-8562

NPI assigned

Aug 13, 2008

Last updated

Aug 13, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Medical Foundation of Central Mississippi, Inc

  dba Baptist Occupational Medical Clinic - Gluckstadt

  • Family Medicine Physician
  • Madison, MS
  • NPI 1508989039
  NPD (past)
• Medical Foundation of Central Ms

  dba Baptist Medical Clinic-Brandon

  • Family Medicine Physician
  • Brandon, MS
  • NPI 1114264264
  NPD (past)

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

{
    "created_epoch": "1218585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218585600000",
    "number": "1801042536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5156",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374060156",
            "telephone_number": "601-209-0724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 MARKET ST",
            "address_2": "BR-3D",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374022881",
            "telephone_number": "423-751-8562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAK",
        "first_name": "FANNY",
        "name_prefix": "Ms.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-13",
        "last_updated": "2008-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "12104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shahul H Majeed, MD
• Leah Major
• Lynch Monroe Major
• Terrence M Major, D.D.S.
• William Bobo Majors III, MD
• Evana Makhoul, DC
• Cindy Lou Makimaa, RN
• Jennifer Wakefield Maklan, LMT
• Audriana Makoto
• Jessica Yousri Makram, MD

• Family Nurse Practitioner in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2008; 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.