Mrs. Melodie Fagan
Nurse Practitioner - Family Medicine
139 Gaius St
Bucyrus
, Ohio 44820-1508
Mrs. Melodie Fagan
Nurse Practitioner - Family Medicine
139 Gaius St
Bucyrus
, Ohio 44820-1508
(419) 462-5372
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About
Features
Specialties
- Nurse Practitioner - Family Medicine
Languages spoken
- English
Location
First Address
- Mrs. Melodie Fagan
- 700 N Columbus St
- Crestline, OH
- Zip : 44827-1455
- Fax : (419) 462-5372
- Phone : (419) 468-0935
Second Address
- Mrs. Melodie Fagan
- 139 Gaius St
- Bucyrus, OH
- Zip : 44820-1508
- Phone : (419) 563-9855
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LF0000X | Nurse Practitioner - Family Medicine | COA.16997-NP | OH |
National Provider Identifier
| NPI | 1003205576 |
|---|---|
| Provider Name | Mrs. Melodie Fagan |
| First Address | Crestline, OH 44827-1455 |
| Second Address | Bucyrus, OH 44820-1508 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 21/01/2015 |
| Last Update Date | 29/12/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0117339 | (05) | OH |
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.