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1073944971
ANGELA FAGAN
JACKSON, MS
NPI
1073944971
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LA2100X Nurse Practitioner, Acute Care
(Licence: MS R858439)
Enumeration Date
2013-12-03
Last Update Date
2014-11-07
Business Address
-- ANGELA FAGAN
2500 N STATE ST
JACKSON, MS 39216-4500
Phone number: 601-984-6426
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Mailing Address
-- ANGELA FAGAN
2500 N STATE ST
JACKSON, MS 39216-4500
Phone number: 601-984-5500
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