Individual provider · Type 1 NPI
Jacob J. Fountain, FNP
Family Nurse Practitioner · Greenville, SC
NPI number
1497232565
Active
Practice location
225 Enterprise Blvd, Suite 101
Greenville, SC 29615
Mailing address
100 W Faris Rd
Greenville, SC 29605-3002
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | 21977 (SC) |
Family Nurse Practitioner: Definition to come...
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About NPI 1497232565
Jacob J. Fountain, FNP's National Provider Identifier is 1497232565, issued on Jul 23, 2018. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Greenville, SC. The record was last updated on Jul 23, 2018.