LAIRA L FONNER
Individual Provider (NPI-1)
Active
Nurse Practitioner, Psych/Mental Health
Provider Information
- NPI Number
1902645286- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 2431 RIVER RD, MISSOULA, MT, 598041239
- Phone
- (406) 361-5093
Specialties & Taxonomies
Nurse Practitioner, Psych/Mental Health
Primary License: MT #Nur-APRN-LIC-240866