Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Miss. Mary Theresa Fanning, CRNP

Individual provider Family Nurse Practitioner · NPI 1194219097

Miss. Mary Theresa Fanning, CRNP is a Nurse Practitioner in York, Pennsylvania. Qualified in 2018, 8 years ago. Practices with St Agnes Healthcare Inc, a 269-clinician group and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
8
Licensed in
PA
In the registry since
2018
What do these letters mean?
CRNP — Certified Registered Nurse Practitioner
The title Pennsylvania and some other states use for a nurse practitioner.

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Practice location Address checks out

2350 Freedom Way Ste 200
York, PA 17402-8200
Phone: (717) 812-5120
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence SP018724 (PA)

Record details

NPI number1194219097
Entity typeIndividual (Type 1)
GenderFemale
Credentials CRNP
Sole proprietorNo
NPI enumeratedJune 15, 2018
Last updated in NPPESJanuary 24, 2020
Certification dateJanuary 24, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice St Agnes Healthcare Inc — 269 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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