Individual
MRS. SUSAN C. FAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
1040 CHEVELLE DR, BATON ROUGE, LA 70806-7805
(225) 343-9505
(225) 343-9141
Mailing address
1040 CHEVELLE DR, BATON ROUGE, LA 70806-7805
(225) 343-9505
(225) 343-9141
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
094363
LA
Other
Enumeration date
05/06/2013
Last updated
05/06/2013
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