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NPI Code Detail

MEDICARE: ERIN KIMBRELLIE FORTNER RBT

MEDICARE: ERIN KIMBRELLIE FORTNER RBT
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
1106S00000XBehavior TechnicianRBT-25-499610FL

General Provider Information

NPI Number : 1871457895
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIN KIMBRELLIE FORTNER RBT
Provider Business Mailing Address
First Line : 8317 FRONT BEACH RD STE 23
Second Line :
City : PANAMA CITY BEACH
State : FL
Zip : 32407-4893
Country : US
Telephone Number : 850-710-0741
Fax Number :
Provider Business Practice Location Address
First Line : 8317 FRONT BEACH RD STE 23
Second Line :
City : PANAMA CITY BEACH
State : FL
Zip : 32407-4893
Country : US
Telephone Number : 850-710-0741
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/13/2025
Last Update Date : 12/13/2025

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