Individual
MARSHA L FOUNTAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2639 MIAMI ST, 4TH FLOOR, SAINT LOUIS, MO 63118-3929
(314) 361-1630
(314) 361-3302
Mailing address
900 E LA HARPE, KIRKSVILLE, MO 63501-4520
(660) 665-1962
(660) 665-3989
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2002021802
MO
Other
Enumeration date
10/31/2011
Last updated
10/31/2011
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