Individual
BRENTENEY FORTUNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C, CRNP
Contact information
Practice address
101 HOUSTON LAKE RD, FULTON, MS 38843-8992
(662) 891-1889
Mailing address
101 HOUSTON LAKE RD, FULTON, MS 38843-8992
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
3-002837
AL
363LF0000X
Family Nurse Practitioner
Primary
908070
MS
Other
Enumeration date
11/07/2024
Last updated
08/13/2026
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