Healthcare Provider Details

I. General information

NPI: 1942147699
Provider Name (Legal Business Name): RACHEL MARIE FORTNEY FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7944 WATTS RD APT 117
MADISON WI
53719-3816
US

IV. Provider business mailing address

7944 WATTS RD APT 117
MADISON WI
53719-3816
US

V. Phone/Fax

Practice location:
  • Phone: 608-459-0125
  • Fax:
Mailing address:
  • Phone: 608-459-0125
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number17979-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: