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Individual

NEDRA S FORTSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
AGPCNP-BC, RN

Contact information

Practice address
802 N JEFFERSON ST, ALBANY, GA 31701-2363
(229) 888-7445
(229) 888-7421
Mailing address
PO BOX 71802, ALBANY, GA 31708-1802
(770) 330-8496
(229) 435-6173

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN131505
GA
363LA2200X
Adult Health Nurse Practitioner
RN131505
GA
363LG0600X
Gerontology Nurse Practitioner
RN131505
GA

Other

Enumeration date
07/26/2013
Last updated
08/19/2014
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