Individual provider · Type 1 NPI
Courtney Fagan, REGISTERED NURSE
Diabetes Educator Registered Nurse · Racine, WI
NPI number
1972098697
Active
Practice location
3805 Spring Street, Bldg A - Suite 311
Racine, WI 53405-1600
Mailing address
6316 37th Ave
Kenosha, WI 53142-3364
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Diabetes Educator Registered Nurse Primary | 163WD0400X | 184877-30 (WI) |
Diabetes Educator Registered Nurse: Definition to come...
About NPI 1972098697
Courtney Fagan, REGISTERED NURSE's National Provider Identifier is 1972098697, issued on Jun 25, 2018. The primary taxonomy on file is Diabetes Educator Registered Nurse (163WD0400X), and the practice location is in Racine, WI. The record was last updated on Jun 25, 2018.