Fagan, Sheryl Diane

Fagan, Sheryl Diane is an individual health care provider with primary practice located at 4211 Van Dyke Rd Suite 200, Lutz FL 33558-8005. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Fagan, Sheryl Diane can be contacted via phone (813) 264-6490.

Contact Information

Primary practice address
4211 Van Dyke Rd Suite 200 Lutz FL 33558-8005
Phone: (813) 264-6490
Fax: (813) 443-8143
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X ARNP1662752 Florida

Profile Details

NPI number 1295055242
LBN Legal business name Fagan, Sheryl Diane
Credentials A.R.N.P.
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 1st, 2010
Last updated Jul 12th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295055242 NPPES
Florida MEDICAID 002400000

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