National Provider Identifier Database

COURTNEY FAGAN, REGISTERED NURSE – NPI #1972098697
Diabetes Educator


Contact Information

COURTNEY FAGAN, REGISTERED NURSE
3805 SPRING STREET
BLDG A - SUITE 311
RACINE, WI53405-1600
Phone: 262-687-6345
Fax:
Website:
Specialty Taxonomy Code
* Diabetes Educator 163WD0400X

* Indicates primary specialty

NPI Profile & details for COURTNEY FAGAN

NPI Number 1972098697
Credentials REGISTERED NURSE
Entity Individual
Enumeration date 06/25/2018
Last updated 06/25/2018 - About 8 years ago
Sole proprietor1 Yes
Identifiers
  • WI License #: 184877-30
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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