Individual
COURTNEY FORTNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1024 M.L.K. JR. DR., MARKS, MS 38646
(662) 326-3502
Mailing address
1024 MARTIN LUTHER KING DR, MARKS, MS 38646-1832
(662) 326-3502
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
904455
MS
363LP2300X
Primary Care Nurse Practitioner
Primary
905127
MS
Other
Enumeration date
12/31/2021
Last updated
05/26/2022
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