Individual
FONTAINE WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2350 MIAMI VALLEY DR STE 500, CENTERVILLE, OH 45459-4780
(937) 293-1622
(937) 245-6308
Mailing address
6680 POE AVE STE 200, DAYTON, OH 45414-2855
(937) 293-1622
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
APRN.CNP.17004
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0203376
—
OH
Enumeration date
10/28/2014
Last updated
12/31/2020
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