Individual
TAMMY FORTIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
59 BANGOR ST, HOULTON, ME 04730-1740
(207) 528-2285
(207) 528-2880
Mailing address
PO BOX 500, PATTEN, ME 04765-0500
(207) 528-2285
(207) 528-2880
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
R048589
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
047805
ANTHEM NUMBER
ME
01
—
119411700
FEDERAL W/C GROUP
ME
01
—
144828
AETNA GROUP
ME
01
—
203814
NHIC GROUP PTAN
ME
05
—
282780099
—
ME
01
—
4961926001
CIGNA
ME
01
—
P45527
HARVARD PILGRAM
ME
Enumeration date
06/06/2006
Last updated
04/04/2016
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