Individual
KAITLIN MARIE FAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4100 CARMEL RD, CHARLOTTE, NC 28226-6150
(704) 542-9210
Mailing address
4100 CARMEL RD, CHARLOTTE, NC 28226-6150
(704) 542-9210
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5019669
NC
Other
Enumeration date
02/27/2024
Last updated
03/06/2024
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