Provider Demographics
NPI:1063649804
Name:LAFOUNTAIN, JEANNE KAY (RN)
Entity Type:Individual
Prefix:MS
First Name:JEANNE
Middle Name:KAY
Last Name:LAFOUNTAIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:182 WESTWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-1063
Mailing Address - Country:US
Mailing Address - Phone:740-972-3600
Mailing Address - Fax:614-293-9401
Practice Address - Street 1:452 W 10TH AVE
Practice Address - Street 2:SUITE H4211A
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210-1240
Practice Address - Country:US
Practice Address - Phone:614-366-1231
Practice Address - Fax:614-293-9401
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-19
Last Update Date:2009-06-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH134700163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant