Individual
PAIGE ALYN FORTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
1721 S STEPHENSON AVE, IRON MOUNTAIN, MI 49801-3637
(906) 776-5600
Mailing address
613 W B ST, IRON MOUNTAIN, MI 49801-2723
(906) 396-0646
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704373815
MI
363LA2100X
Acute Care Nurse Practitioner
Primary
4704373815
MI
Other
Enumeration date
06/26/2023
Last updated
10/01/2024
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