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1902645286
LAIRA L FONNER
MISSOULA, MT
NPI
1902645286
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LP0808X Nurse Practitioner Psychiatric/Mental Health
(Licence: MT NUR-APRN-LIC-240866)
Enumeration Date
2024-05-24
Last Update Date
2024-09-13
Business Address
LAIRA L FONNER
2431 RIVER RD
MISSOULA, MT 59804-1239
Phone number: 406-361-5093
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Mailing Address
LAIRA L FONNER
328 3RD ST W
WHITEFISH, MT 59937-3017
Phone number: 406-890-8767
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