Doctor Name: | LINDA FAGAN |
NPI Number: | 1205878428 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | RN101672 |
Business Practice Address: | 1113 E Oglethorpe Hwy Hinesville, GA - 313131200 |
Business Phone Number: | 9128762173 |
Business Fax Number: | 9123688033 |
Mailing Address: | 1113 E Oglethorpe Hwy, HINESVILLE |
State: | GA |
Postal Code: | 313131200 |
Phone Number: | 9128762173 |
Fax Number: | 9123688033 |
NPI Enumeration Date: | 06/12/2006 |
NPI Last Update Date: | 11/13/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LW0102X |
License Number: | RN101672 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Women's Health |
Taxonomy Definition: |