Individual
JESSICA H. FORTUNAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
9669 E 146TH ST STE 250, NOBLESVILLE, IN 46060-5006
(317) 621-9926
(317) 621-9677
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
(317) 621-7520
(317) 806-1112
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
71002547A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200882800
—
IN
01
—
71002547A
NP LICENSE #
IN
Enumeration date
01/08/2008
Last updated
11/27/2023
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