Individual provider · Type 1 NPI

Lynn Eberts Fagerman, PNP

Pediatric Nurse Practitioner · Grand Rapids, MI

NPI number 1073553194 Active

Practice location

426 Michigan St NE, Suite 102
Grand Rapids, MI 49503-5623

Fax (616) 391-3950

Mailing address

100 Michigan St NE, Mc 845
Grand Rapids, MI 49503-2560

Specialties and licenses

TaxonomyCodeLicense
Pediatric Nurse Practitioner Primary 363LP0200X4704123571 (MI)

Pediatric Nurse Practitioner: Definition to come...

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About NPI 1073553194

Lynn Eberts Fagerman, PNP's National Provider Identifier is 1073553194, issued on Jun 7, 2006. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Grand Rapids, MI. The record was last updated on Jan 6, 2025.