Individual
MS. SHERYL DIANE FAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.R.N.P.
Contact information
Practice address
4211 VAN DYKE RD, SUITE 200, LUTZ, FL 33558-8005
(813) 264-6490
(813) 443-8143
Mailing address
PO BOX 10744, CLEARWATER, FL 33757-8744
(727) 532-0002
(727) 266-4928
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
ARNP1662752
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002400000
—
FL
Enumeration date
06/01/2010
Last updated
07/12/2016
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