Rhianna Fagan, APRN
Nurse Practitioner, Family in St Johns, FL. Individual provider (NPI-1).
NPI number1265296263
StatusActive
Last updated in NPPESApr 30, 2024
Details
- NPI
- 1265296263
- Entity type
- Individual (NPI-1)
- Name
- Rhianna Fagan
- Credential
- APRN
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Feb 9, 2024
- Certification date
- Apr 30, 2024
- Last updated
- Apr 30, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - NURSE PRACTITIONER
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | APRN11031165 | FL | Yes |
Practice location
150 Longleaf Pine Pkwy Ste 200St Johns, FL 32259-7529
Phone 904-652-0800
Mailing address
4800 Belfort RdJacksonville, FL 32256-6004
Phone 904-398-7205
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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