Provider Demographics
NPI:1588046155
Name:FANCHER, DEVIN
Entity type:Individual
Prefix:
First Name:DEVIN
Middle Name:
Last Name:FANCHER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 HOSPITAL RD
Mailing Address - Street 2:
Mailing Address - City:RED BAY
Mailing Address - State:AL
Mailing Address - Zip Code:35582-3858
Mailing Address - Country:US
Mailing Address - Phone:256-376-2032
Mailing Address - Fax:256-376-2055
Practice Address - Street 1:221 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:RED BAY
Practice Address - State:AL
Practice Address - Zip Code:35582-3858
Practice Address - Country:US
Practice Address - Phone:256-376-2032
Practice Address - Fax:256-376-2055
Is Sole Proprietor?:No
Enumeration Date:2015-06-19
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-177157363LF0000X
MSR891550363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily