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Individual
KATIE FOUNTAIN
Active
Individual
KATIE FOUNTAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-08451
NC
363A00000X
Physician Assistant
007228
GA
363A00000X
Physician Assistant
6001
SC
363A00000X
Physician Assistant
Primary
67837
CA
363A00000X
Physician Assistant
PA.1620
AL
363A00000X
Physician Assistant
PA9121303
FL
Other
Enumeration date
05/14/2014
Last updated
03/18/2026
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