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Contact Information

ADAM T FANNIN, MSN, MHA, APRN-CNP
3100 MACCORKLE AVE SE STE 205
CHARLESTON, WV25304-1228
 Phone: 740-395-6011
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Critical Care Medicine

163WC0200X
 

Nurse Practitioner

363L00000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for ADAM T FANNIN · (Male)

NPI # 1275415580
Status Active
Credentials MSN, MHA, APRN-CNP
Entity Individual
Enumeration date 07/25/2025
Last updated 10/27/2025 - About 7 months ago
Sole proprietor 1 No
Identifiers
  • WV License # 108310
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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