Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Angela Fagan

Individual provider Acute Care Nurse Practitioner · NPI 1073944971

Angela Fagan is a Nurse Practitioner in Jackson, Mississippi. Qualified in 2013, 13 years ago. Practices with State of Mississippi - University of Mississippi Medical Center, a 952-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Mississippi.

Years since qualifying
13
Licensed in
MS
In the registry since
2013
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Practice location Address checks out

2500 N State St
Jackson, MS 39216-4500
Phone: (601) 984-6426
Fax: (601) 984-5503
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence R858439 (MS)

Record details

NPI number1073944971
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedDecember 3, 2013
Last updated in NPPESNovember 7, 2014
Mailing address2500 N State St, Jackson, MS 39216-4500

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice State Of Mississippi - University Of Mississippi Medical Center — 952 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Jackson