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NPI Profile for COURTNEY FAGAN in RACINE, WI.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Diabetes Educator |
163WD0400X |
| NPI # | 1972098697 |
|
| Status | Active | |
| Credentials | REGISTERED NURSE | |
| Entity | Individual | |
| Enumeration date | 06/25/2018 | |
| Last updated | 06/25/2018 - About 8 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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COURTNEY FAGAN
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COURTNEY FAGAN, REGISTERED NURSE