Individual
LORI ANN FAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10475 BANYAN BREEZE BLVD, LAND O LAKES, FL 34638-5720
(304) 598-1560
(304) 322-0601
Mailing address
10475 BANYAN BREEZE BLVD, LAND O LAKES, FL 34638-5720
(304) 598-1560
(304) 322-0601
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
486
WV
Other
Enumeration date
02/01/2007
Last updated
01/06/2026
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