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Individual
MRS. DEVONA L. FAGAN
Active
Individual
MRS. DEVONA L. FAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
N.P.
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
NP17793
CA
363LA2100X
Acute Care Nurse Practitioner
Primary
17793
CA
Other
Enumeration date
09/23/2008
Last updated
06/27/2023
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