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DAJUAN FANNING
NPI 1376102434
Licensed Practical Nurse in Southfield, MI

Active since June 11, 2019
17072 NEW HAMPSHIRE DR, SOUTHFIELD, MI 48075(313) 213-7470 Get Directions Write a Review

NPPES record last updated: June 11, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dajuan Fanning NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DAJUAN FANNING (NPI 1376102434) is an individual licensed practical nurse in Southfield, Michigan, licensed in Michigan (4703116420) and active in the NPI registry since June 2019.

NPPES Registry Identity

NPI1376102434
Entity TypeIndividualMale
Primary Taxonomy164W00000X
Provider Legal NameDAJUAN FANNING
Location Address17072 NEW HAMPSHIRE DRSouthfield, MI 48075-2972
Mailing Address17072 New Hampshire DrSouthfield, MI 48075-2972 · (313) 213-7470
Phone(313) 213-7470
Sole ProprietorNo
Enumeration DateJune 11, 2019
✔ NPI 1376102434 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers
Taxonomy Code164W00000X
License✔ Licensed in MI · 4703116420
Definition
A licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
Also ListedChore ProviderTaxonomy 372500000X
Also ListedHome Health AideTaxonomy 374U00000X
Also ListedPrevention ProfessionalTaxonomy 405300000X · License 4703116420 (MI)
17072 NEW HAMPSHIRE DR, Southfield, MI 48075
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Other Identifiers 2

Other4703116420MI · Bcbs
Medicaid4703116420MI

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHRISTINE DANIEL
Licensed Practical Nurse
17072 NEW HAMPSHIRE DR
SOUTHFIELD, MI 48075
Oakland County (313) 310-4794

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dajuan Fanning's NPI number?

The NPI number for Dajuan Fanning is 1376102434. It was assigned to this individual provider in the NPPES registry on June 11, 2019.

Where is Dajuan Fanning located?

Dajuan Fanning practices at 17072 New Hampshire Dr, Southfield, MI 48075. The listed phone number is (313) 213-7470.

What is Dajuan Fanning's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

When was this NPI record last updated?

The NPPES record for Dajuan Fanning was last updated on June 11, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.