Individual
ROBERT FORTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1241 SHAWHAN RD, MORROW, OH 45152-9695
(513) 865-5204
Mailing address
PO BOX 632572, CINCINNATI, OH 45263-2572
(513) 891-0022
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
072814
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000553250
ANTHEM
—
05
—
2001032200
—
IN
05
—
2544769
—
OH
01
—
617574
WELLCARE
KY
05
—
74009903
—
KY
Enumeration date
07/13/2005
Last updated
09/25/2025
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