Individual
MICHAEL MCKINLEY FOUNTAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
79-1019 HAUKAPILA ST, KEALAKEKUA, HI 96750-7920
(808) 322-9311
Mailing address
79-1019 HAUKAPILA ST, KEALAKEKUA, HI 96750-7920
(808) 322-9311
(478) 296-2801
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN-2633
HI
363LF0000X
Family Nurse Practitioner
APRN-2633-0
HI
363LF0000X
Family Nurse Practitioner
RN240666
GA
Other
Enumeration date
10/03/2017
Last updated
05/03/2023
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