Individual
SHMYRA FOUNTAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
79-1019 HAUKAPILA ST, KEALAKEKUA, HI 96750-7920
(808) 322-9311
Mailing address
1301 SOLANA BLVD STE 2200, WESTLAKE, TX 76262-1769
(817) 767-6209
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
93914
HI
363L00000X
Nurse Practitioner
Primary
APRN-4333
HI
Other
Enumeration date
09/07/2023
Last updated
12/07/2023
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