Fagan, Kelly Anne
Fagan, Kelly Anne is an individual health care provider with primary practice located at 90 Asheland Ave , Asheville NC 28801-4021. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Physician Assistants & Advanced Practice Nursing Providers / Pediatrics. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Fagan, Kelly Anne can be contacted via phone (828) 254-2700.Contact Information
Primary practice address
90 Asheland Ave
Asheville NC 28801-4021
Phone: (828) 254-2700
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 363LP0808X | F400995-1 | New York |
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X | F381648-1 | New York |
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 363LP0808X | 229768 | North Carolina |
Profile Details
NPI number | 1508928920 |
---|---|
LBN Legal business name | Fagan, Kelly Anne |
Credentials | NPP |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Dec 14th, 2006 |
Last updated | Nov 14th, 2014 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1508928920 | NPPES |
New York | MEDICAID | 03240911 |
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