Individual
MRS. ELLEN FONTANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
4110 GUADALUPE ST, AUSTIN, TX 78751-4296
(512) 419-2770
Mailing address
4110 GUADALUPE ST, AUSTIN, TX 78751-4296
(512) 419-2770
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
686654
TX
Other
Enumeration date
10/16/2008
Last updated
10/07/2011
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