MEDICARE: MS. ASHLEY FORTNEY APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN9355814	FL
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN11045356	FL

General Provider Information

NPI Number	:	1144806407
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ASHLEY FORTNEY APRN

Provider Business Mailing Address
First Line	:	4400 N CONGRESS AVE STE 203
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-3221
Country	:	US
Telephone Number	:	561-285-3623
Fax Number	:	863-638-5637

Provider Business Practice Location Address
First Line	:	4400 N CONGRESS AVE STE 203
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-3221
Country	:	US
Telephone Number	:	561-285-3623
Fax Number	:	863-638-5637

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/18/2021
Last Update Date	:	02/06/2026

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