MEDICARE: JEANNEMARIE FOURNIER ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	G163669	IA

General Provider Information

NPI Number	:	1245990878
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEANNEMARIE FOURNIER ARNP

Provider Business Mailing Address
First Line	:	PO BOX 15
Second Line	:
City	:	CEDAR RAPIDS
State	:	IA
Zip	:	52406-0015
Country	:	US
Telephone Number	:	319-900-4525
Fax Number	:	319-303-7070

Provider Business Practice Location Address
First Line	:	4403 1ST AVE SE STE 220
Second Line	:
City	:	CEDAR RAPIDS
State	:	IA
Zip	:	52402-3221
Country	:	US
Telephone Number	:	319-900-4525
Fax Number	:	319-303-7070

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/22/2021
Last Update Date	:	02/10/2026

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