Individual
MRS. TARA T.S. FAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
250 FLAT ROCK PL, WESTBROOK, CT 06498-1565
(860) 358-3760
Mailing address
7 PARTRIDGE HOLLOW RD, KILLINGWORTH, CT 06419-1025
(860) 452-4042
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4711
CT
Other
Enumeration date
08/03/2011
Last updated
03/02/2017
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