Healthcare Provider Details

I. General information

NPI: 1891099552
Provider Name (Legal Business Name): CINDY FORTNER CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2011
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

830 ROCKFORD ST
MOUNT AIRY NC
27030-5322
US

IV. Provider business mailing address

76 PEACHTREE RD STE 300
ASHEVILLE NC
28803-3505
US

V. Phone/Fax

Practice location:
  • Phone: 336-719-7000
  • Fax:
Mailing address:
  • Phone: 828-210-9386
  • Fax: 901-382-8070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number007859
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR103598
License Number StateAR
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN88183
License Number StateWV
# 4
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberC002999
License Number StateAR
# 5
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number3018457
License Number StateKY
# 6
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number15505
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: