Individual
KATIE ELIZABETH FONTAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3213 ROGERS RD, WAKE FOREST, NC 27587-3805
(919) 562-2288
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(919) 562-2288
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-09144
NC
Other
Enumeration date
06/25/2019
Last updated
02/04/2026
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