Individual
KATERINA FAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ACNPC-AG
Contact information
Practice address
320 RACETRACK RD NW STE 100C, FORT WALTON BEACH, FL 32547-1796
(850) 863-0883
Mailing address
320 RACETRACK RD NW STE 100C, FORT WALTON BEACH, FL 32547-1796
(850) 863-0883
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
1046195
TX
363LA2100X
Acute Care Nurse Practitioner
Primary
APRN11031708
FL
Other
Enumeration date
06/29/2021
Last updated
04/01/2024
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