Individual provider · Type 1 NPI
Laura Jean Fountain, CPNP-PC
Pediatric Nurse Practitioner · Chicago, IL
NPI number
1699213496
Active
Practice location
225 E Chicago Ave
Chicago, IL 60611-2991
Mailing address
222 E Pearson St Apt 2407
Chicago, IL 60611-7367
Other practice locations
- 15 Baynard Park, Newnan, GA 30265-6413 · (770) 251-5253
- 3400 Old Milton Pkwy, Alpharetta, GA 30005-3707 · (770) 751-6111
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | RN250573 (GA) |
| Pediatric Nurse Practitioner Primary | 363LP0200X | 209.018082 (IL) |
Pediatric Nurse Practitioner: Definition to come...
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About NPI 1699213496
Laura Jean Fountain, CPNP-PC's National Provider Identifier is 1699213496, issued on Feb 1, 2017. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Chicago, IL. The record was last updated on Nov 19, 2018.