Fortune, Robin Dale

Fortune, Robin Dale is an sole proprietor health care provider with primary practice located at 5099 Sportsman Lake Rd , Elizabethtown KY 42701-8216. He recently has only one registered license in Technologists, Technicians & Other Technical Service Providers / Surgical Technologist, which is considered as his primary health care specialty. Fortune, Robin Dale can be contacted via phone (270) 369-8984.

Contact Information

Primary practice address
5099 Sportsman Lake Rd Elizabethtown KY 42701-8216
Phone: (270) 369-8984
Fax: (270) 369-8562
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Technologists, Technicians & Other Technical Service Providers / Surgical Technologist 246ZS0410X SA050 Kentucky

Profile Details

NPI number 1073668067
LBN Legal business name Fortune, Robin Dale
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 23rd, 2007
Last updated Jul 8th, 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 1073668067 NPPES
Kentucky Other SA050 KBML CERTIFICATION NO.

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