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Individual

MARIE-MICHELE FORTILLUS

Active
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Individual

MARIE-MICHELE FORTILLUS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
502964
NY
363LP1700X
Perinatal Nurse Practitioner
F390054
NY
363LW0102X
Women's Health Nurse Practitioner
Primary
F420771
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
F420771
WOMEN'S HEALTH NP LICENSE
NY
Enumeration date
10/10/2007
Last updated
10/10/2007
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