Provider Demographics
NPI:1881455590
Name:FORTENER, ALISHA J (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:ALISHA
Middle Name:J
Last Name:FORTENER
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 W 14TH ST
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:IL
Mailing Address - Zip Code:61081-2220
Mailing Address - Country:US
Mailing Address - Phone:815-742-8033
Mailing Address - Fax:
Practice Address - Street 1:509 W 14TH ST
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:IL
Practice Address - Zip Code:61081-2220
Practice Address - Country:US
Practice Address - Phone:815-742-8033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-19
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.029196363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily