COURTNEY FAGAN (NPI# 1972098697) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972098697 |
| Entity Type | Individual |
| Full Name | COURTNEY FAGAN |
| Credential | REGISTERED NURSE |
| Practice Address |
3805 Spring Street Bldg A - Suite 311 Racine WI 53405-1600 |
| Mailing Address |
6316 37th Ave Kenosha WI 53142-3364 |
| Practice Telephone | 2626876345 |
| Mailing Telephone | 2627527240 |
| Enumeration Date | 2018-06-25 |
| Last Update Date | 2018-06-25 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WD0400X |
Registered Nurse Specialization: Diabetes Educator |
184877-30 | WI | Nursing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184183642 | Courtney Lynne Fagan | Specialist/Technologist | 8225 Fl-54, New Port Richey, FL 34655 | 2019-03-14 |
| Street Address |
3805 SPRING STREET BLDG A - SUITE 311 |
| City | RACINE |
| State | WI |
| Zip Code | 53405-1600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609407923 | Anita Kathy Nykaza | Dietitian, Registered | 3805 A Suite 311, Racine, WI 53405 | 2020-01-27 |
| 1023666062 | Shawn L Drulia | Physician Assistant | 3805 Spring St #320, Racine, WI 53405 | 2019-09-03 |
| 1235627720 | Oxygen One, Inc. | Durable Medical Equipment & Medical Supplies | 3805a Spring Street, Suite 210, Racine, WI 53405 | 2018-04-30 |
| 1356838650 | Melissa Metzger | Psychologist | 2340 Mohr Ave, Racine, WI 53405 | 2018-04-23 |
| 1689029217 | Melissa Ileen Swainston | Nurse Practitioner | 3803 Spring St., Suite Number 410, Racine, WI 53405 | 2016-05-02 |
| 1215305487 | Denetta Lauraelaine Flowers | Licensed Practical Nurse | 4311 Durand Ave., #104, Mt.pleasant, WI 53405 | 2015-09-04 |
| 1841675204 | Colleen Koderca | Registered Nurse | 3317-meachem Rd, Racine, WI 53405 | 2015-07-28 |
| 1790102986 | Georges Wakim | Specialist/Technologist | 3811 Spring St., Suite 102, Racine, WI 53405 | 2014-03-25 |
| 1982021176 | Matthew F Patzke | Specialist/Technologist | 3811 Spring Street Suite 102, Racine, WI 53405 | 2014-03-25 |
| 1073930269 | Jessica Geisler | Specialist/Technologist | 3811 Spring Street Suite #102, Racine, WI 53405 | 2014-03-25 |
| Find all providers in zip 53405 | ||||
| Taxonomy Code | 163WD0400X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Diabetes Educator |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376016196 | Georgia Ann Horner | Registered Nurse | 3805a Spring St Ste 311, Mount Pleasant, WI 53405-1600 | 2019-01-03 |
| 1962970350 | Elizabeth Mowbray | Registered Nurse | 36500 Aurora Dr Ste 330, Summit, WI 53066-4899 | 2018-11-05 |
| 1659882942 | Linda K Davis | Registered Nurse | 2323 N Lake Dr Rm W2039, Milwaukee, WI 53211-4508 | 2017-10-13 |
| 1124539556 | Roxanne Weber | Registered Nurse | 146 E. Geneva Square, Lake Geneva, WI 53147 | 2017-10-12 |
| 1255876462 | Rebecca Delain | Registered Nurse | 616 Aurora Dr, Green Bay, WI 54302-4871 | 2016-12-23 |
| 1558688713 | Patricia Jean Celek | Registered Nurse | 8901 W. Lincoln Avenue, Awamc, West Allis, WI 53227 | 2010-04-28 |
| 1952525529 | Sheryl H Ashby | Registered Nurse | 125 Old Abe Rd, Lac Du Flambeau, WI 54538-9386 | 2007-04-12 |
| 1700928850 | Leann Tilden | Registered Nurse | 1818 N. Meade St., Appleton Medical Center, Appleton, WI 54911 | 2007-02-13 |
| 1467078196 | Lynn J Estacio | Registered Nurse | 9000 W Sura Ln, Greenfield, WI 53228-3477 | 2020-06-18 |
| 1700413283 | Michelle Yvonne Degrave | Registered Nurse | 2845 Greenbrier Rd, Green Bay, WI 54311-6519 | 2020-03-25 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.