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1821724386
ALEXIS BYRD FOUNTAIN
VIDALIA, GA
NPI
1821724386
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: GA RN274392)
Enumeration Date
2022-07-27
Last Update Date
2022-07-27
Business Address
ALEXIS BYRD FOUNTAIN FNP-C
122 ALICE COLEMAN DRIVE
VIDALIA, GA 30474
Phone number: 912-805-2273
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Mailing Address
ALEXIS BYRD FOUNTAIN FNP-C
297 R T LANE
TARRYTOWN, GA 30470
Phone number:
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