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General NPI Number Information
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NPI Number | 1639683196
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Entity Type | Individual
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Provider Name | NATALIA FORTUNATO
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Gender | Female
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Dates
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Enumeration Date | 11/20/2017
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 624 WILLOWICK RD
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City | CARMEL
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State | IN
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Zip | 46032-1861
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Country | US
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Telephone | 317-509-4505
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Fax |
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Provider Business Mailing Address
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Address Line | 6057 KIDMAN LN
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City | SPRING HILL
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State | TN
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Zip | 37174-2208
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | F308309-1
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License Number State | NY
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