Rose Ciccariello Fagan, CNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

0198739-22 Issued in OH

Practice address

3640 Colonel Glenn Hwy
051 Student Union
Dayton, OH 45435-0001

Phone

(937) 775-2552

Fax

(937) 775-3260

NPI assigned

Mar 24, 2008

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Ms. Rose Ciccariello Fagan Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Wright State University Student Health Services

  • Family Nurse Practitioner
  • Dayton, OH
  • NPI 1417947037
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1206316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238544000000",
    "number": "1184896714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 750002",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "45475",
            "telephone_number": "937-775-2552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3640 COLONEL GLENN HWY",
            "address_2": "051 STUDENT UNION",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454350001",
            "telephone_number": "937-775-2552",
            "fax_number": "937-775-3260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CICCARIELLO FAGAN",
        "first_name": "ROSE",
        "name_prefix": "Ms.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-24",
        "last_updated": "2009-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "0198739-22",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROSE",
            "last_name": "CICCARIELLO FAGAN",
            "prefix": "MS.",
            "credential": "MN, CNP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Amber Lyn Church, AT
• Pamela R Church, CDCA
• Brannon Russell Churchwell, D.O.
• Juliana Cialdella, DO
• Victor Louis Ciaramitaro, RPH
• Angela Cicchinelli, CDCA
• Alicia Ciccone
• Joseph L Cimoch, LPCC-S
• Courtney Marie Cinko, M.D.
• Circle of Care HHC LLC

• Nurse Practitioner in Dayton, OH
• Providers in Dayton, OH by specialty
• Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.