Individual
MRS. ANDRA J FONTAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
100 MERCY WAY, JOPLIN, MO 64804-4524
(417) 782-7722
(417) 556-3098
Mailing address
100 MERCY WAY, JOPLIN, MO 64804-4524
(417) 782-7722
(417) 556-3098
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
45766
KS
363LF0000X
Family Nurse Practitioner
Primary
MO2001019721
MO
Other
Enumeration date
01/15/2008
Last updated
08/24/2020
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