Provider Demographics
NPI:1609478163
Name:FOURNIER, PATRICK (HIS)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:FOURNIER
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 11TH AVE S
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-4849
Mailing Address - Country:US
Mailing Address - Phone:406-761-0011
Mailing Address - Fax:
Practice Address - Street 1:1301 11TH AVE S
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-4654
Practice Address - Country:US
Practice Address - Phone:888-230-0875
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-10
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT225OtherHEARING INSTRUMENT SPECIALIST