Fornes, Jorge E.

Fornes, Jorge E. is an individual health care provider with primary practice located at Corner Of Route N12 And N7 , Fort Defiance AZ 86504. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Fornes, Jorge E. can be contacted via phone (928) 729-8000.

Contact Information

Primary practice address
Corner Of Route N12 And N7 Fort Defiance AZ 86504
Phone: (928) 729-8000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X ARNP1495112 Florida

Profile Details

NPI number 1619998762
LBN Legal business name Fornes, Jorge E.
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 22nd, 2006
Last updated May 22nd, 2019 - about 5 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 1619998762 NPPES
Florida MEDICAID 3036502 00
Florida Other G2860

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