Fortenberry, Kimberly Phillips

Fortenberry, Kimberly Phillips is an sole proprietor health care provider with primary practice located at 1202 S Tyler St , Covington LA 70433-2330. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Fortenberry, Kimberly Phillips can be contacted via phone (985) 898-4000.

Contact Information

Primary practice address
1202 S Tyler St Covington LA 70433-2330
Phone: (985) 898-4000
Fax: (985) 898-4394
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 901488 Mississippi
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X RN072659 Louisiana

Profile Details

NPI number 1750345005
LBN Legal business name Fortenberry, Kimberly Phillips
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 13th, 2006
Last updated Nov 3rd, 2023 - about 3 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1750345005 NPPES
Louisiana MEDICAID 1569755
Louisiana Other 430057274

Popular Providers