MEDICARE: FRANCES ANN FORTNEY LPN

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
1	164W00000X	Licensed Practical Nurse	164WOOOOX	MI

General Provider Information

NPI Number	:	1508263062
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRANCES ANN FORTNEY LPN

Provider Business Mailing Address
First Line	:	3033 S COLDWATER RD LOT 54
Second Line	:
City	:	MT PLEASANT
State	:	MI
Zip	:	48858-9668
Country	:	US
Telephone Number	:	989-598-6686
Fax Number	:

Provider Business Practice Location Address
First Line	:	3033 S COLDWATER RD LOT 54
Second Line	:
City	:	MT PLEASANT
State	:	MI
Zip	:	48858-9668
Country	:	US
Telephone Number	:	989-598-6686
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/28/2014
Last Update Date	:	11/28/2014

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Directions to “ FRANCES ANN FORTNEY LPN” Practice Location

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