Individual
KADEE FORTINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
239 N STATE RD STE 101, OWOSSO, MI 48867-9075
(989) 743-3415
(989) 743-6180
Mailing address
239 N STATE RD STE 101, OWOSSO, MI 48867-9075
(989) 743-3415
(989) 743-6180
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601013781
MI
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
11/01/2023
Last updated
03/11/2026
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