IndividualActive
Angela Fagan
NPI 1073944971 · Acute Care Nurse Practitioner · Jackson, MS
Provider details
- NPI number
- 1073944971
- Entity type
- Individual
- Primary specialty
- Acute Care Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Female
- Sole proprietor
- No
- License
- R858439 (MS)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
2500 N State St
Jackson, MS 39216-4500
Phone: (601) 984-6426
Fax: (601) 984-5503
Approximate (ZIP-level) locationGet directions
Mailing address
2500 N State St
Jackson, MS 39216-4500
Registry dates
- Enumerated
- 2013-12-03
- Last updated
- 2014-11-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.