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NPI Code Detail

MEDICARE: LINDA FAGAN NP

MEDICARE: LINDA FAGAN NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LW0102XWomen's Health Nurse PractitionerRN101672GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1205878428
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDA FAGAN NP
Provider Business Mailing Address
First Line : 1113 E OGLETHORPE HWY
Second Line :
City : HINESVILLE
State : GA
Zip : 31313-1200
Country : US
Telephone Number : 912-876-2173
Fax Number : 912-368-8033
Provider Business Practice Location Address
First Line : 1113 E OGLETHORPE HWY
Second Line :
City : HINESVILLE
State : GA
Zip : 31313-1200
Country : US
Telephone Number : 912-876-2173
Fax Number : 912-368-8033
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2006
Last Update Date : 11/13/2012

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