Provider Demographics
NPI:1245990878
Name:FOURNIER, JEANNE MARIE ANTOINETTE (ARNP)
Entity type:Individual
Prefix:
First Name:JEANNE MARIE
Middle Name:ANTOINETTE
Last Name:FOURNIER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 15
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52406-0015
Mailing Address - Country:US
Mailing Address - Phone:319-900-4525
Mailing Address - Fax:319-303-7070
Practice Address - Street 1:4403 1ST AVE SE STE 220
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-3221
Practice Address - Country:US
Practice Address - Phone:319-900-4525
Practice Address - Fax:319-303-7070
Is Sole Proprietor?:No
Enumeration Date:2021-12-22
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IAG163669363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health