Individual
AGNES FAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
269 FISH POND RD, SEWELL, NJ 08080-3047
(856) 863-9999
(856) 863-9666
Mailing address
269 FISH POND RD, SEWELL, NJ 08080-3047
(856) 863-9999
(856) 863-9666
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
26NJ00851200
NJ
Other
Enumeration date
10/16/2018
Last updated
10/16/2018
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