MS. STACY LOUISE FAGAN (NPI# 1841444098) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841444098 |
| Entity Type | Individual |
| Full Name | MS. STACY LOUISE FAGAN |
| Credential | P.A. |
| Practice Address |
2512 N Meridian Ave Oklahoma City OK 73107-1035 |
| Practice Telephone | 4056055415 |
| Practice Fax Number | 4056055310 |
| Mailing Telephone | 4056055415 |
| Enumeration Date | 2008-11-13 |
| Last Update Date | 2011-02-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
1779 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2512 N MERIDIAN AVE |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73107-1035 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184640112 | Windsor Park Medical Clinic | Family Medicine | 2512 N Meridian Ave, Oklahoma City, OK 73107-1035 | 2006-07-14 |
| 1073172607 | Kehdinga Nukuna | Nurse Practitioner | 2512 N Meridian Ave, Oklahoma City, OK 73107-1035 | 2019-06-07 |
| 1952649204 | Jill Whitney Frost | Physician Assistant | 2512 N Meridian Ave, Oklahoma City, OK 73107-1035 | 2013-01-22 |
| 1104070259 | Windsor Park Medical Clinic | Physician Assistant | 2512 N Meridian Ave, Oklahoma City, OK 73107-1035 | 2008-11-14 |
| 1699823617 | Windsor Park Medical Clinic, LLC | Family Medicine | 2512 N Meridian Ave, Oklahoma City, OK 73107-1035 | 2007-01-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144747999 | Ellen Rose Pochyly | Counselor | 2617 General Pershing Boulevard, Oklahoma City, OK 73107 | 2017-08-23 |
| 1609399906 | Carrie Ann Moore | Counselor | 2617 General Pershing Blvd., Oklahoma City, OK 73107 | 2017-07-19 |
| 1821511320 | Diana Lynn Spencer | Counselor | 2617generalpershingblvd, Oklahoma City, OK 73107 | 2017-07-18 |
| 1861859514 | Catherine Evans | Counselor | 500 N Meridian Ave Ste 409, Oklahoma City, OK 73107 | 2016-01-26 |
| 1871964551 | Kizzy Frazier | Student in an Organized Health Care Education/Training Program | 1233 N Warren Pl, Oklahoma City, OK 73107 | 2015-10-07 |
| 1538550629 | Oklahoma Department of Mental Health and Substance Abuse | Case Management | 2625 General Pershing Boulevard, Oklahoma City, OK 73107 | 2015-02-10 |
| 1952702276 | Andale Healthcare, LLC | Clinic/Center | 2305 N. Meridian, Oklahoma City, OK 73107 | 2014-09-05 |
| 1114339348 | John Walls | Psychologist | 2012 North Villa Avenue, Oklahoma City, OK 73107 | 2014-05-22 |
| 1376970517 | Latrice Warrior | Community/Behavioral Health | 2625 General Pershing Drive, Oklahoma City, OK 73107 | 2013-10-02 |
| 1326485541 | Debra Sue Vaughan | Counselor | 2617 Genral Pershing Blvd, Oklahoma City, OK 73107 | 2013-05-29 |
| Find all providers in zip 73107 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982172029 | William Landon Ross | Physician Assistant | 3705 W Memorial Rd Ste 101, Oklahoma City, OK 73134-1508 | 2018-11-07 |
| 1639646656 | Jacob Allbritton | Physician Assistant | 10824 Admiral Dr, Oklahoma City, OK 73162-6843 | 2018-10-29 |
| 1073004768 | Shelby Teel | Physician Assistant | 1200 Everett Dr # 8305, Oklahoma City, OK 73104-5047 | 2018-05-29 |
| 1255871349 | Michele Starr | Physician Assistant | 409 Nw 39th St, Oklahoma City, OK 73118-8415 | 2017-03-08 |
| 1972042141 | Nathan Carl Kadavy | Physician Assistant | 440 N Portland Ave, Suite 1000, Oklahoma City, OK 73107-6110 | 2017-02-21 |
| 1487191946 | Neilee Wood | Physician Assistant | 8121 Nw 119th St, Oklahoma City, OK 73162-1110 | 2017-01-23 |
| 1508316530 | Shayniel Stears | Physician Assistant | 16201 Gossamer Way, Oklahoma City, OK 73165-1503 | 2016-10-13 |
| 1386016566 | D'amber Nicole Chambers | Physician Assistant | 1918 Ne 23rd St, Oklahoma City, OK 73111-3328 | 2015-10-27 |
| 1700263928 | Micaela Lupov | Physician Assistant | 101 N Robinson Ave Ste 200, Oklahoma City, OK 73102 | 2015-04-27 |
| 1710380001 | Whitney Ward | Physician Assistant | 4120 W Memorial Rd Ste 300, Oklahoma City, OK 73120-9322 | 2014-10-01 |
| Find all providers in OKLAHOMA CITY | ||||
| City | OKLAHOMA CITY |
| Zip Code | 73107 |
Please comment or provide details below to improve the information on MS. STACY LOUISE FAGAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.