Healthcare Provider Details

I. General information

NPI: 1093515983
Provider Name (Legal Business Name): EMILY FORTIER CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2025
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6301 S MCCLINTOCK DR STE 215
TEMPE AZ
85283-3394
US

IV. Provider business mailing address

2545 W FRYE RD STE 9
CHANDLER AZ
85224-6273
US

V. Phone/Fax

Practice location:
  • Phone: 480-820-6657
  • Fax: 480-730-0803
Mailing address:
  • Phone: 480-505-4258
  • Fax: 480-505-3689

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number250326
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: