Individual
AMARION FORTENBERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
309 LAFAYETTE ST, COLUMBIA, MS 39429-2059
(601) 731-8446
(769) 213-2422
Mailing address
309 LAFAYETTE ST, COLUMBIA, MS 39429-2059
(601) 731-8446
(769) 213-2422
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
291U00000X
Clinical Medical Laboratory
—
MS
374U00000X
Home Health Aide
—
—
376J00000X
Homemaker
—
MS
376K00000X
Nurse's Aide
—
—
385H00000X
Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
06/25/2025
Last updated
06/25/2025
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