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Individual

LAIRA L FONNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2431 RIVER RD, MISSOULA, MT 59804-1239
(406) 361-5093
Mailing address
328 3RD ST W, WHITEFISH, MT 59937-3017
(406) 890-8767

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
NUR-APRN-LIC-240866
MT

Other

Enumeration date
05/24/2024
Last updated
09/13/2024
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