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NPI Code Detail

MEDICARE: PAULA FORTIN FNP-C

MEDICARE:   PAULA  FORTIN  FNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner1463AK
2363LF0000XFamily Nurse Practitioner4481MN

General Provider Information

NPI Number : 1215338355
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAULA FORTIN FNP-C
Provider Business Mailing Address
First Line : 7650 CURRELL BLVD STE 330
Second Line :
City : WOODBURY
State : MN
Zip : 55125-8209
Country : US
Telephone Number : 651-738-7800
Fax Number :
Provider Business Practice Location Address
First Line : 7650 CURRELL BLVD STE 330
Second Line :
City : WOODBURY
State : MN
Zip : 55125-8209
Country : US
Telephone Number : 651-738-7800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2014
Last Update Date : 10/29/2024

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Directions to “ PAULA FORTIN FNP-C” Practice Location

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