Individual
SARAH KAY FOUNTAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
970 LAKELAND DR STE 61, JACKSON, MS 39216-4634
(601) 982-7850
Mailing address
970 LAKELAND DR STE 61, JACKSON, MS 39216-4634
(601) 405-3690
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
905690
MS
Other
Enumeration date
12/05/2022
Last updated
09/03/2024
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