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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508928920 NPPES
New York MEDICAID 03240911

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