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LYNN EBERTS FAGERMAN PNP
NPI 1073553194
Nurse Practitioner - Pediatrics in Grand Rapids, MI

Active since June 07, 2006
426 MICHIGAN ST NE, SUITE 102, GRAND RAPIDS, MI 49503(616) 391-2957(616) 391-3950 Get Directions Write a Review

NPPES record last updated: January 6, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jan 6, 2025, Mar 8, 2021 (2 updates tracked since 2021).

About Lynn Eberts Fagerman Pnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LYNN EBERTS FAGERMAN PNP (NPI 1073553194) is an individual pediatrics provider in Grand Rapids, Michigan, licensed in Michigan (4704123571) and active in the NPI registry since June 2006.

NPPES Registry Identity

NPI1073553194
Entity TypeIndividualFemale
Primary Taxonomy363LP0200X
Provider Legal NameLYNN EBERTS FAGERMANCredential: PNP
Location Address426 MICHIGAN ST NE, SUITE 102Grand Rapids, MI 49503-5623
Mailing Address100 Michigan St Ne, Mc 845Grand Rapids, MI 49503-2560
Phone(616) 391-2957
Fax(616) 391-3950
Sole ProprietorNo
Enumeration DateJune 7, 2006
Last NPPES UpdateJanuary 6, 20252 updates tracked since enumeration
NPPES CertifiedJanuary 6, 2025
✔ NPI 1073553194 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0200X
License✔ Licensed in MI · 4704123571
426 MICHIGAN ST NE, Grand Rapids, MI 49503
Open in Google Maps ↗

Other Identifiers 3

Medicaid4493574MI
Other5008700690MI · Bcbs Pin
Other500D111300MI · Bcbs Group

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. NICHOLAS ALEXANDER STEPHANOFF M.D.
Family Medicine
426 MICHIGAN ST NE
GRAND RAPIDS, MI 49503
Kent County (616) 267-7888
RITA DEKKER
Nurse Practitioner
426 MICHIGAN ST NE
GRAND RAPIDS, MI 49503
Kent County (616) 391-2778
JENNIFER MARIE SHANLEY CNM
Advanced Practice Midwife
426 MICHIGAN ST NE
GRAND RAPIDS, MI 49503
Kent County (616) 391-3302
MICHIGAN STREET OPTICAL
Durable Medical Equipment & Medical Supplies
426 MICHIGAN ST NE, SUITE 101
GRAND RAPIDS, MI 49503
Kent County (616) 459-1844
AMY COX MD
Family Medicine
426 MICHIGAN ST NE
GRAND RAPIDS, MI 49503
Kent County (616) 267-7888
TAMI JOY MICHELE DO
Obstetrics & Gynecology
426 MICHIGAN ST NE
GRAND RAPIDS, MI 49503
Kent County (616) 391-3302
MARGUERITE B SOWERS PA-C
Physician Assistant (Medical)
426 MICHIGAN ST NE, SUITE 201
GRAND RAPIDS, MI 49503
Kent County (616) 459-8209
MOLLY JANE TIESENGA APRN
Nurse Practitioner (Adult Health)
426 MICHIGAN ST NE
GRAND RAPIDS, MI 49503
Kent County (616) 267-8338

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lynn Fagerman's NPI number?

The NPI number for Lynn Fagerman is 1073553194. It was assigned to this individual provider in the NPPES registry on June 7, 2006.

Where is Lynn Fagerman located?

Lynn Fagerman practices at 426 Michigan St NE Suite 102, Grand Rapids, MI 49503. The listed phone number is (616) 391-2957.

What is Lynn Fagerman's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

When was this NPI record last updated?

The NPPES record for Lynn Fagerman was last updated on January 6, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.