Magen Suzann Fann, RN

Individual provider Active NPI Registered Nurse · Mayfield, KY

NPI 1558079368 · NPPES record last updated Nov 10, 2022

Key facts

NPI
1558079368
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
1148755 (KY)
Practice address
1253 Paris Rd
Mayfield, KY 42066-4989
Phone
(270) 247-2455
Fax
(270) 247-7841
NPI assigned
Nov 10, 2022
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
1148755KYMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1148755 KY Yes

Addresses

Primary practice location

1253 Paris Rd
Mayfield, KY 42066-4989

Mailing address

1253 Paris Rd
Mayfield, KY 42066-4989
Phone (270) 247-2455

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address magen.fann@va.gov Health Information Exchange (HIE)

Other providers in Mayfield, KY

All providers in Mayfield, KY · Registered Nurse in Kentucky

Sources for this page

Verify at the official NPI Registry.