Provider Demographics
NPI:1710062971
Name:FORTUNE, CHERYL F (RNFA)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:F
Last Name:FORTUNE
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 POPLAR GROVE DRIVE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30306
Mailing Address - Country:US
Mailing Address - Phone:404-892-9019
Mailing Address - Fax:
Practice Address - Street 1:2801 NORTH DECATUR RD STE 200
Practice Address - Street 2:ATLANTA KNEE AND SPORTS MEDICINE
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30033
Practice Address - Country:US
Practice Address - Phone:404-296-5005
Practice Address - Fax:404-296-9417
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN050722163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant