EDNITA CHARZETTE STREET FOUNTAIN

TERRE HAUTE, IN
NPI1578141024
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: MS  901702)
Additional Taxonomies163W00000X Registered Nurse
(Licence: MS  889173)
Enumeration Date2021-03-29
Last Update Date2021-06-16
Business Address
Dr. EDNITA CHARZETTE STREET FOUNTAIN DNP, CRNA
1421 N 7TH ST
TERRE HAUTE, IN 47807-1005
Phone number: 812-231-4608
Mailing Address
Dr. EDNITA CHARZETTE STREET FOUNTAIN DNP, CRNA
3157 BASIN REFUGE RD
LUCEDALE, MS 39452-7688
Phone number: 601-947-0366