Provider Demographics
NPI:1508853433
Name:FOURNIER, FRAN V (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:FRAN
Middle Name:V
Last Name:FOURNIER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MRS
Other - First Name:FRAN
Other - Middle Name:V
Other - Last Name:VANGELDER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ARNP
Mailing Address - Street 1:3700 WASHINGTON ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-8259
Mailing Address - Country:US
Mailing Address - Phone:954-962-0338
Mailing Address - Fax:954-962-2357
Practice Address - Street 1:3700 WASHINGTON ST
Practice Address - Street 2:SUITE 500
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-8259
Practice Address - Country:US
Practice Address - Phone:954-962-0338
Practice Address - Fax:954-962-2357
Is Sole Proprietor?:No
Enumeration Date:2005-10-05
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2573942363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY6153ZMedicare ID - Type Unspecified