Individual
MISS JENIFER KAY FORTNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5650 COVENTRY LN, FORT WAYNE, IN 46804-7140
(217) 508-8478
Mailing address
5650 COVENTRY LN, FORT WAYNE, IN 46804-7140
(217) 508-8478
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
10002104A
IN
Other
Enumeration date
06/16/2016
Last updated
12/11/2019
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