National Provider Identifier
Petel B Fagan
Petel B Fagan is listed in the NPPES registry with a primary specialty of Licensed Practical Nurse in Rochester, NY and a listed phone number of (585) 754-3391.
Profile Overview
- NPI
- 1275836777
- Provider Type
- Individual
- Primary Specialty
- Licensed Practical Nurse
- Enumeration Date
- December 06, 2010
- Last Updated
- December 06, 2010
Practice Location
- 54 Jennifer Cir
- Rochester, NY 14606-3350
Phone: (585) 754-3391
Specialties
- Licensed Practical Nurse (164W00000X)
Full Record
- NPI
- 1275836777
- Entity Type
- Individual
- Last Name
- Fagan
- First Name
- Petel
- Middle Name
- B
- Name Prefix
- Mrs.
- Mailing Street Address
- 54 Jennifer Cir
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14606-3350
- Mailing Country
- US
- Mailing Phone
- (585) 754-3391
- Practice Street Address
- 54 Jennifer Cir
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14606-3350
- Practice Country
- US
- Practice Phone
- (585) 754-3391
- Enumeration Date
- December 06, 2010
- Last Updated
- December 06, 2010
- Sex
- Female
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Licensed Practical Nurse (164W00000X)