Individual
ELIZABETH A FAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTIONER
Contact information
Practice address
2131 S 17TH ST, WILMINGTON, NC 28401-7407
(910) 667-3000
Mailing address
1202 MEDICAL CENTER DR, WILMINGTON, NC 28401-7307
(910) 617-6705
(910) 431-4048
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5011917
NC
363LA2200X
Adult Health Nurse Practitioner
5011917
NC
Other
Enumeration date
07/02/2019
Last updated
09/08/2025
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