ELLEN MARIE FOUNTAIN

KANSAS CITY, MO
NPI1801756739
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: MO  2026006490)
Enumeration Date2025-11-13
Last Update Date2026-06-24
Business Address
ELLEN MARIE FOUNTAIN
2401 GILLHAM RD
KANSAS CITY, MO 64108-4619
Phone number: 816-234-3000
Mailing Address
ELLEN MARIE FOUNTAIN
2401 GILLHAM RD ATTN PROVIDER ENROLLMENT DEPT
KANSAS CITY, MO 64108-4619
Phone number: 816-701-5200