Individual
TINA MARIE FORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, NP-C
Contact information
Practice address
218 N MAIN ST, EUFAULA, OK 74432-1633
(918) 689-7705
Mailing address
4196 HIGHWAY 62 412 STE A, HARDY, AR 72542-8002
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
83414
OK
Other
Enumeration date
07/31/2019
Last updated
10/15/2025
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