Individual
MS. SHANNA FORTUNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
22 S GREENE ST, BALTIMORE, MD 21201-1544
(410) 328-8107
Mailing address
22 S GREENE ST, BALTIMORE, MD 21201-1544
(410) 328-8107
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
306629
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
R191607
MD
Other
Enumeration date
04/02/2014
Last updated
12/22/2020
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