| Provider / Organization | NPI | Date Certified |
|---|---|---|
| SYDNEY FONTAINE | 1366160921 | 2022-12-03 |
Sydney Fontaine is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1366160921. Registration indicates Sydney Fontaine is a provider of access to adult/geriatric primary care providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (Physician Assistant, ) (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (All Other Specialties & Provider Types, ) (Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers)
| Entity Type | Individual |
| Provider Name | Sydney Fontaine |
| Practice Office Address | 30 N 1900 E # 3B400 SALT LAKE CITY, UT US |
| Practice Office Telephone | 8015817719 |
| Mailing Address | 30 N 1900 E # 3B400 SALT LAKE CITY, UT 841320002 US |
| Direct Messaging Address [CDA/CCD/TXT] | [email protected] | Direct University of Utah |
| Code | Practice | License No State |
|---|---|---|
| 363A00000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician AssistantAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Physician Assistant Physician Assistants & Advanced Practice Nursing Providers Physician Assistant All Other Specialties & Provider Types Physician Assistant Physician Assistants & Advanced Practice Nursing Providers | 12919118-1206
UT |