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Individual

MR. STEVEN MARK FOUNTAIN

Active
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Individual

MR. STEVEN MARK FOUNTAIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ARNP

Taxonomy

Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
123456
FL
246ZC0007X
Surgical Assistant
94976
TX
363L00000X
Nurse Practitioner
Primary
9329413
FL
363LA2100X
Acute Care Nurse Practitioner
9329413
FL
363LA2200X
Adult Health Nurse Practitioner
9329413
FL
363LG0600X
Gerontology Nurse Practitioner
9329413
FL

Other

Enumeration date
04/12/2007
Last updated
01/26/2016
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