Individual
KATELYN FORTENBERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
305 LANGDON ST, SOMERSET, KY 42503-2750
(606) 679-7441
Mailing address
7419 FALLS RIDGE CT, LOUISVILLE, KY 40241-6401
(502) 777-7207
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
07/14/2020
Last updated
09/21/2021
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