Individual
MS. JENNIFER H FORTENBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2401 PARK DR STE 101, HARRISBURG, PA 17110-9303
(717) 686-9842
Mailing address
3421 CONCORD RD, YORK, PA 17402-9001
(717) 851-1405
(717) 851-6969
Taxonomy
Speciality
Code
Description
License number
State
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
2002014284
MO
363AM0700X
Medical Physician Assistant
Primary
MA056018
PA
363AS0400X
Surgical Physician Assistant
2002014284
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1620177
GATEWAY MEDICARE ASSURED
PA
01
—
2888522
HIGHMARK BLUE SHIELD-FREEDOM BLUE
PA
Enumeration date
12/31/2008
Last updated
10/25/2019
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