Individual
KELLY L. FOURNIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPM
Contact information
Practice address
105 S SMALLEY ST, NIXA, MO 65714-7829
(931) 209-0771
Mailing address
105 S SMALLEY ST, NIXA, MO 65714-7829
(931) 209-0771
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
20020019
—
Other
Enumeration date
04/26/2020
Last updated
04/26/2020
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