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Individual
PAUL S FONTANA
Active
Individual
PAUL S FONTANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
N34935
ID
363L00000X
Nurse Practitioner
Primary
NP733A
ID
363L00000X
Nurse Practitioner
RN00161870
WA
363LA2200X
Adult Health Nurse Practitioner
AP30007150
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
807415800
MEDICAID
ID
05
—
9648015
—
WA
Enumeration date
05/10/2006
Last updated
04/18/2024
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