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Search › Arizona › 163W00000X

Jack Lafountain, RN

NPI 1710239181 · on the registry since 2012

Practice

Address
12033 Agency Rd
Parker, AZ 85344
Phone
(580) 451-0202
Organisation at this address
Pihc
Dhhs Ihs Phoenix Area
Lucy Charlene Nichols
Dhhs Ihs Phoenix Area
Dhhs Ihs Phoenix Area
Inferred from a shared address, not stated in the registry.
Clinicians at this address
255

Registry record

Primary taxonomy
163W00000X
163W00000X
Licence states on file
OK
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2012-10-10

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Arizona