Individual Healthcare Provider
Katerina Fagan, ACNPC-AG
Provider's NPPES record last updated: May 19, 2026
Overview
- Entity Type
- Individual Healthcare Provider
- NPI
- 1356911671
- Primary Specialty
- Urology
- Practice Location
- Crestview, Florida
- Sole Proprietor
- Yes
Federal Screening
NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.
List of Excluded Individuals/Entities (LEIE)
HHS Office of Inspector General
No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.
- Source data
- September 10, 2026
- Records indexed
- 84,001
- Screened
- Sep 19, 2026, 11:28 AM UTC
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
SAM.gov Exclusions
U.S. General Services Administration
SAM.gov Exclusions was not checked.
SAM.gov screening is not configured on this deployment. No SAM check has been performed.
- Screened
- Not checked
This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
Searches OIG LEIE and SAM.gov by name and reviews every potential match.
Specialties & Taxonomies
- Primary
Urology
Allopathic & Osteopathic Physicians
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
Taxonomy code 208800000X Nurse Practitioner
Acute Care
Physician Assistants & Advanced Practice Nursing Providers
Definition to come...
Taxonomy code 363LA2100X
Provider-Reported License Information
- Urology (Florida)
- 11031708
- Nurse Practitioner (Florida)
- APRN11031708
- Nurse Practitioner (Texas)
- 1046195
Practice Locations
Practice Location
435 Brookmeade Dr
Crestview, Florida 32539-7304
Phone: (850) 605-0550
Additional Practice Location
320 Racetrack Rd Nw Ste 100c
Fort Walton Beach, Florida 32547-1796
Phone: (850) 863-0883
Record Information
- Enumeration Date
- June 29, 2021
- Provider's NPPES Record Last Updated
- May 19, 2026
- Certification Date
- May 19, 2026
- NPISignal NPPES Dataset
- August 2026
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