Melissa Marie Fagan
Nurse Practitioner - Family Medicine Nurse Practitioner - Community Health
202 10th Street Se
Cedar Rapids
, Iowa 52403-2404
Melissa Marie Fagan
Nurse Practitioner - Family Medicine Nurse Practitioner - Community Health
202 10th Street Se
Cedar Rapids
, Iowa 52403-2404
(319) 399-2085
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About
Features
Specialties
- Nurse Practitioner - Community Health
- Nurse Practitioner - Family Medicine
Languages spoken
- English
Location
First Address
- Melissa Marie Fagan
- Po Box 3178
- Cedar Rapids, IA
- Zip : 52406-3178
- Fax : (319) 399-2085
- Phone : (319) 398-1583
Second Address
- Melissa Marie Fagan
- 202 10th Street Se
- Cedar Rapids, IA
- Zip : 52403-2404
- Fax : (319) 399-2039
- Phone : (319) 398-1545
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 363LC1500X | Nurse Practitioner - Community Health | A080649 | IA |
| Y | 363LF0000X | Nurse Practitioner - Family Medicine | A080649 | IA |
National Provider Identifier
| NPI | 1194842849 |
|---|---|
| Provider Name | Melissa Marie Fagan |
| First Address | Cedar Rapids, IA 52406-3178 |
| Second Address | Cedar Rapids, IA 52403-2404 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 26/03/2007 |
| Last Update Date | 09/10/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| P10570 | (02) | IA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.