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Individual
PRINCEWILL FONTA
Active
Individual
PRINCEWILL FONTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP70059722
WA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
L8-0010342
DE
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
RN2307255
MA
Other
Enumeration date
07/19/2022
Last updated
05/19/2026
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