Fortenberry, Charles Edward

Fortenberry, Charles Edward is an individual health care provider with primary practice located at 1103 16Th Ave Se , Decatur AL 35601-3595. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as his primary health care specialty. Fortenberry, Charles Edward can be contacted via phone (256) 350-0362.

Contact Information

Primary practice address
1103 16Th Ave Se Decatur AL 35601-3595
Phone: (256) 350-0362
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 1-049601 Alabama

Profile Details

NPI number 1023234648
LBN Legal business name Fortenberry, Charles Edward
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 18th, 2007
Last updated Oct 22nd, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023234648 NPPES
Alabama Other 51006076 BLUE CROSS BLUE SHIELD AL
Alabama MEDICAID 891017506 BLUE CROSS BLUE SHIELD AL

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