Individual provider

MRS. DEVONA L. FAGAN, N.P.

CMS NPPES lists MRS. DEVONA L. FAGAN as an individual provider record with NPI 1013167402. The current record reports a primary practice location in BOULDER CITY, NV and primary taxonomy code 363LA2100X.

NPI 1013167402Record type Type 1Primary taxonomy 363LA2100X

Type 1 NPIs identify individual healthcare providers. How to read this profile

01

Practice locations

  1. Primary practice location
    895 ADAMS BLVDBOULDER CITY, NV 890052235

Only source-designated practice locations are shown here. Mailing addresses are not presented as practice locations.

02

Taxonomy information

  • 163WE0003XAdditional reported taxonomy
  • 363LA2100XPrimary reported taxonomy

Taxonomy codes describe provider classifications reported to NPPES. Repeated identical codes are shown once, with primary-reported status preserved. They are not licenses, certifications, quality measures, or NPIFolio specialty labels. Read the taxonomy methodology.

03

NPI record information

NPI status
Enumerated in NPPES
Enumeration date
September 23, 2008

An NPI is a federal identifier. Enumeration and lifecycle information does not establish medical-license status, current practice, disciplinary history, provider quality, or whether a provider is accepting patients.