Fortenberry, Charles Edward
Fortenberry, Charles Edward is an individual health care provider with primary practice located at 1103 16Th Ave Se , Decatur AL 35601-3595. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as his primary health care specialty. Fortenberry, Charles Edward can be contacted via phone (256) 350-0362.Contact Information
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 1-049601 | Alabama |
Profile Details
NPI number | 1023234648 |
---|---|
LBN Legal business name | Fortenberry, Charles Edward |
Credentials | Registered Nurse (RN) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Apr 18th, 2007 |
Last updated | Oct 22nd, 2007 - about 18 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1023234648 | NPPES |
Alabama | Other | 51006076 | BLUE CROSS BLUE SHIELD AL |
Alabama | MEDICAID | 891017506 | BLUE CROSS BLUE SHIELD AL |
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