Jill Fagan, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

259190 Issued in AZ

Practice address

743 Miller Valley Rd
Prescott, AZ 86301-1813

Phone

(928) 777-9600

Fax

(855) 449-5560

NPI assigned

Aug 21, 2026

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1787270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789430400000",
    "number": "1417863002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "743 MILLER VALLEY RD",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011813",
            "telephone_number": "928-777-9600",
            "fax_number": "855-449-5560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "743 MILLER VALLEY RD",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011813",
            "telephone_number": "928-777-9600",
            "fax_number": "855-449-5560"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450 S Willard St",
            "address_purpose": "LOCATION",
            "city": "Cottonwood",
            "state": "AZ",
            "postal_code": "863266743",
            "country_code": "US",
            "telephone_number": "928-634-9573",
            "fax_number": "928-634-0135",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "560 N Camino Mercado Ste 7",
            "address_purpose": "LOCATION",
            "city": "Casa Grande",
            "state": "AZ",
            "postal_code": "851225759",
            "country_code": "US",
            "telephone_number": "520-836-5538",
            "fax_number": "844-722-0049",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "725 W Elliot Rd Bldg 3",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852335301",
            "country_code": "US",
            "telephone_number": "480-963-6144",
            "fax_number": "480-899-1404",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "285 N Broad St",
            "address_purpose": "LOCATION",
            "city": "Globe",
            "state": "AZ",
            "postal_code": "855012503",
            "country_code": "US",
            "telephone_number": "928-425-8200",
            "fax_number": "928-425-8406",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "309 Lake Havasu Ave S",
            "address_purpose": "LOCATION",
            "city": "Lake Havasu City",
            "state": "AZ",
            "postal_code": "864039309",
            "country_code": "US",
            "telephone_number": "928-453-1970",
            "fax_number": "928-855-7229",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2035 Mesquite Ave",
            "address_purpose": "LOCATION",
            "city": "Lake Havasu City",
            "state": "AZ",
            "postal_code": "864035894",
            "country_code": "US",
            "telephone_number": "928-208-4598",
            "fax_number": "888-571-6436",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3530 S Val Vista Dr Ste C101",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852977318",
            "country_code": "US",
            "telephone_number": "480-840-9155",
            "fax_number": "480-840-9320",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3931 N Stockton Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Kingman",
            "state": "AZ",
            "postal_code": "864092426",
            "country_code": "US",
            "telephone_number": "928-385-7100",
            "fax_number": "885-538-3114",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1923 McCulloch Blvd N Ste 101",
            "address_purpose": "LOCATION",
            "city": "Lake Havasu City",
            "state": "AZ",
            "postal_code": "864036120",
            "country_code": "US",
            "telephone_number": "928-208-4611",
            "fax_number": "928-453-4645",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3552 W Baseline Rd Ste 140",
            "address_purpose": "LOCATION",
            "city": "Laveen",
            "state": "AZ",
            "postal_code": "853393042",
            "country_code": "US",
            "telephone_number": "602-635-6951",
            "fax_number": "602-635-6952",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9171 W Thunderbird Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "AZ",
            "postal_code": "853814872",
            "country_code": "US",
            "telephone_number": "623-877-0100",
            "fax_number": "623-328-8713",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13926 W Bell Rd",
            "address_purpose": "LOCATION",
            "city": "Surprise",
            "state": "AZ",
            "postal_code": "853743863",
            "country_code": "US",
            "telephone_number": "623-850-0026",
            "fax_number": "623-850-0027",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2501 N Stockton Hill Rd Ste 108",
            "address_purpose": "LOCATION",
            "city": "Kingman",
            "state": "AZ",
            "postal_code": "864014140",
            "country_code": "US",
            "telephone_number": "928-255-5050",
            "fax_number": "888-571-5897",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "24871 S Ellsworth Rd Ste 100-458",
            "address_purpose": "LOCATION",
            "city": "Queen Creek",
            "state": "AZ",
            "postal_code": "851421574",
            "country_code": "US",
            "telephone_number": "602-300-0898",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "87 S State Route 89",
            "address_purpose": "LOCATION",
            "city": "Chino Valley",
            "state": "AZ",
            "postal_code": "863235687",
            "country_code": "US",
            "telephone_number": "928-404-1488",
            "fax_number": "866-232-8580",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "26224 N Tatum Blvd",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850507500",
            "country_code": "US",
            "telephone_number": "480-663-9632",
            "fax_number": "623-748-1914",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12075 E State Route 69 Ste B",
            "address_purpose": "LOCATION",
            "city": "Prescott Valley",
            "state": "AZ",
            "postal_code": "863274569",
            "country_code": "US",
            "telephone_number": "928-772-1673",
            "fax_number": "928-772-1674",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3251 N Windsong Dr",
            "address_purpose": "LOCATION",
            "city": "Prescott Valley",
            "state": "AZ",
            "postal_code": "863141222",
            "country_code": "US",
            "telephone_number": "928-772-2582",
            "fax_number": "928-319-1729",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1300 S 20th Ave",
            "address_purpose": "LOCATION",
            "city": "Safford",
            "state": "AZ",
            "postal_code": "855463301",
            "country_code": "US",
            "telephone_number": "928-428-3122",
            "fax_number": "928-428-7917",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2500 Canyon Rd Ste A1",
            "address_purpose": "LOCATION",
            "city": "Bullhead City",
            "state": "AZ",
            "postal_code": "864428492",
            "country_code": "US",
            "telephone_number": "928-704-4499",
            "fax_number": "928-704-4949",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1620 E Wilcox Dr",
            "address_purpose": "LOCATION",
            "city": "Sierra Vista",
            "state": "AZ",
            "postal_code": "856352778",
            "country_code": "US",
            "telephone_number": "520-459-0362",
            "fax_number": "520-458-1585",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2171 W Orange Grove Rd",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857413118",
            "country_code": "US",
            "telephone_number": "520-297-3907",
            "fax_number": "520-989-3486",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "286 S Lenzner Ave",
            "address_purpose": "LOCATION",
            "city": "Sierra Vista",
            "state": "AZ",
            "postal_code": "856355685",
            "country_code": "US",
            "telephone_number": "520-452-0388",
            "fax_number": "877-281-8622",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5902 E Pima St",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857124322",
            "country_code": "US",
            "telephone_number": "520-886-5315",
            "fax_number": "877-209-7377",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18275 N 59th Ave",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853081260",
            "country_code": "US",
            "telephone_number": "602-564-0078",
            "fax_number": "602-564-1154",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21321 E Ocotillo Rd Ste 133",
            "address_purpose": "LOCATION",
            "city": "Queen Creek",
            "state": "AZ",
            "postal_code": "851425995",
            "country_code": "US",
            "telephone_number": "480-987-5525",
            "fax_number": "480-987-5115",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4135 S Power Rd Ste 129",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852123627",
            "country_code": "US",
            "telephone_number": "480-751-3091",
            "fax_number": "480-751-3095",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3336 E Chandler Heights Rd Ste 132",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852984264",
            "country_code": "US",
            "telephone_number": "480-988-4645",
            "fax_number": "480-988-4745",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAGAN",
        "first_name": "JILL",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-08-21",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "259190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2026; 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.