Fagerman, Lynn Eberts

Fagerman, Lynn Eberts is an individual health care provider with primary practice located at 426 Michigan St Ne Suite 102, Grand Rapids MI 49503-5623. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Fagerman, Lynn Eberts can be contacted via phone (616) 391-2957.

Contact Information

Primary practice address
426 Michigan St Ne Suite 102 Grand Rapids MI 49503-5623
Phone: (616) 391-2957
Fax: (616) 391-3950
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 4704123571 Michigan

Profile Details

NPI number 1073553194
LBN Legal business name Fagerman, Lynn Eberts
Credentials Pediatric Nurse Practitioner (PNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 7th, 2006
Last updated Mar 8th, 2021 - about 5 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 1073553194 NPPES
Michigan Other 500D111300 BCBS GROUP
Michigan MEDICAID 4493574 BCBS GROUP
Michigan Other 5008700690 BCBS GROUP

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