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

Katerina Fagan, ACNPC-AG

Individual provider Urology Physician · NPI 1356911671

Katerina Fagan, ACNPC-AG is a Nurse Practitioner in Crestview, Florida. Qualified in 2021, 5 years ago. Practices with North Okaloosa Clinic Corp, a 25-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Florida and Texas.

Years since qualifying
5
Licensed in
FL, TX
In the registry since
2021
Specialties on file
3
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Practice location Address checks out

435 Brookmeade Dr
Crestview, FL 32539-7304
Phone: (850) 605-0550
Fax: (850) 605-0440
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 320 Racetrack Rd Nw Ste 100c, Fort Walton Beach, FL 32547-1796 — (850) 863-0883

Specialties & licences

Urology Physician (primary) Taxonomy 208800000X · Licence 11031708 (FL)
Acute Care Nurse Practitioner Taxonomy 363LA2100X · Licence APRN11031708 (FL)
Acute Care Nurse Practitioner Taxonomy 363LA2100X · Licence 1046195 (TX)

Record details

NPI number1356911671
Entity typeIndividual (Type 1)
GenderFemale
Credentials ACNPC-AG
Sole proprietorYes
NPI enumeratedJune 29, 2021
Last updated in NPPESMay 19, 2026
Certification dateMay 19, 2026

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice North Okaloosa Clinic Corp — 25 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Crestview