Provider Demographics
NPI:1508263062
Name:FORTNEY, FRANCES ANN (LPN)
Entity Type:Individual
Prefix:
First Name:FRANCES
Middle Name:ANN
Last Name:FORTNEY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:FRANCES
Other - Middle Name:ANN
Other - Last Name:FORTNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:3033 S COLDWATER RD LOT 54
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-9668
Mailing Address - Country:US
Mailing Address - Phone:989-598-6686
Mailing Address - Fax:
Practice Address - Street 1:3033 S COLDWATER RD LOT 54
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-9668
Practice Address - Country:US
Practice Address - Phone:989-598-6686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-28
Last Update Date:2014-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI164WOOOOX164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse