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General NPI Number Information
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NPI Number | 1417473612
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Entity Type | Individual
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Provider Name | KENDAL FORTUNE FNP-C
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Gender | Female
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Dates
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Enumeration Date | 08/18/2017
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Last Update Date | 07/18/2024
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Provider Practice Location Address
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Address Line | 1 VILLAGE DR STE 105
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City | ABILENE
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State | TX
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Zip | 79606-2340
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Country | US
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Telephone | 325-704-4381
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Fax |
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Provider Business Mailing Address
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Address Line | 10045 COUNTY ROAD 214
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City | CLYDE
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State | TX
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Zip | 79510-7547
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F07170094
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F07170994
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License Number State | TX
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