Individual
LYNN EBERTS FAGERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
4704123571
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4493574
—
MI
01
—
5008700690
BCBS PIN
MI
01
—
500D111300
BCBS GROUP
MI
Enumeration date
06/07/2006
Last updated
01/06/2025
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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