Individual
AMANDA FORTUNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
530 DUVAL AVE, HOUMA, LA 70364-3102
(504) 201-1900
Mailing address
530 DUVAL AVE, HOUMA, LA 70364-3102
(504) 201-1900
Taxonomy
Speciality
Code
Description
License number
State
163WW0101X
Ambulatory Women's Health Care Registered Nurse
RN126526
LA
207VX0000X
Obstetrics Physician
Primary
AP08064
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00338278
—
MS
05
—
2382063
—
LA
01
—
AP08064
LSBN
LA
01
—
CNM2337
AMCB
—
01
—
RN126526
LSBN
LA
Enumeration date
12/03/2014
Last updated
03/04/2015
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