Individual
GENIA MARIE FORTUNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN.CNP
Contact information
Practice address
126 W MCCONKEY ST, SHREVE, OH 44676-9301
(330) 789-1099
(330) 789-1109
Mailing address
PO BOX 526, SHREVE, OH 44676-0526
(330) 789-1099
(330) 789-1109
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN.CNP.022885
OH
Other
Enumeration date
06/19/2018
Last updated
06/19/2018
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