Individual
LINDA FAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1113 E OGLETHORPE HWY, HINESVILLE, GA 31313-1200
(912) 876-2173
(912) 368-8033
Mailing address
1113 E OGLETHORPE HWY, HINESVILLE, GA 31313-1200
(912) 876-2173
(912) 368-8033
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
RN101672
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000834897D
—
GA
Enumeration date
06/12/2006
Last updated
11/13/2012
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