Individual
MRS. LEONA FONTANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0110840475
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00072031
RAILROAD MEDICARE
VA
Enumeration date
05/11/2006
Last updated
11/27/2023
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