Provider Demographics
NPI:1508989385
Name:FAGAN, FLORENCE MARY (LPN)
Entity Type:Individual
Prefix:MRS
First Name:FLORENCE
Middle Name:MARY
Last Name:FAGAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:FLORENCE
Other - Middle Name:
Other - Last Name:GREENWAY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:14 MAPLE COURT
Mailing Address - Street 2:
Mailing Address - City:MAYS LANDING
Mailing Address - State:NJ
Mailing Address - Zip Code:08330
Mailing Address - Country:US
Mailing Address - Phone:609-476-3481
Mailing Address - Fax:609-476-3298
Practice Address - Street 1:2250 HICKORY RD
Practice Address - Street 2:GENERAL HEALTHCARE RESOURCES INC SUITE 240
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462
Practice Address - Country:US
Practice Address - Phone:888-834-7200
Practice Address - Fax:610-834-3180
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJPN250916L164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse