Individual
MELISSA MARIE FOUNTAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1000 W SOUTH BOULDER RD STE 110, LAFAYETTE, CO 80026-2753
(303) 415-4355
Mailing address
1000 W SOUTH BOULDER RD STE 110, LAFAYETTE, CO 80026-2753
(303) 415-4355
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA0004816
CO
Other
Enumeration date
10/17/2016
Last updated
01/23/2025
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