Individual
LEAH DANIELLE FOUNTAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, NP-C APRN
Contact information
Practice address
555 W 6TH ST, MOUNTAIN HOME, AR 72653-3409
(870) 425-8288
Mailing address
PO BOX 1254, MOUNTAIN HOME, AR 72654-1254
(870) 425-8288
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A005203
AR
Other
Enumeration date
07/08/2017
Last updated
09/25/2019
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