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Individual

MRS. ELLEN CATHERINE FAGAN-PRYOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSN, PMHCNS, RN

Contact information

Practice address
2121 LAKE AVENE, FORT WAYNE, IN 46805-5100
(260) 445-2123
Mailing address
8818 HOFFMAN RD, FORT WAYNE, IN 46816-9595
(260) 639-6767

Taxonomy

Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
28101257A
IN

Other

Enumeration date
09/14/2006
Last updated
03/27/2013
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