Active NPI
Alicia Fannin
- Addiction (Substance Use Disorder) Registered Nurse
- Ironton, OH
National Provider Identifier
1902590995
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Registered Nurse
- License
- 107491
- Practice address
- 2903 S 5TH St
Ironton, OH 45638-2866 - Phone
- (740) 646-6640
- NPI assigned
- Jun 5, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Registered Nurse | 163WA0400X | 107491 | KY | Primary |
Addresses
Primary practice location
2903 S 5TH St
Ironton, OH 45638-2866
Mailing address
2903 S 5TH St
Ironton, OH 45638-2866
Phone (740) 646-6640
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 107491 | KY | MD | Addiction (Substance Use Disorder) Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1685923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685923200000",
"number": "1902590995",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2903 S 5TH ST",
"city": "IRONTON",
"state": "OH",
"postal_code": "456382866",
"telephone_number": "740-646-6640"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2903 S 5TH ST",
"city": "IRONTON",
"state": "OH",
"postal_code": "456382866",
"telephone_number": "740-646-6640"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FANNIN",
"first_name": "ALICIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-05",
"last_updated": "2023-06-05",
"certification_date": "2023-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "163WA0400X",
"taxonomy_group": "",
"desc": "Registered Nurse, Addiction (Substance Use Disorder)",
"state": "KY",
"license": "107491",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ironton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.