Individual provider · Type 1 NPI

Lee Marshall Fagen, NP

Adult Health Nurse Practitioner · Berkeley, CA

NPI number 1275639098 Active

Practice location

2222 Bancroft Ext
Berkeley, CA 94720-4303

Mailing address

2727 Hillegass Ave
Berkeley, CA 94705-1206

Specialties and licenses

TaxonomyCodeLicense
Adult Health Nurse Practitioner Primary 363LA2200XRN373234, NP7501 (CA)

Adult Health Nurse Practitioner: Definition to come...

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About NPI 1275639098

Lee Marshall Fagen, NP's National Provider Identifier is 1275639098, issued on Sep 16, 2006. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in Berkeley, CA. The record was last updated on Jul 8, 2007.