Fortenberry, Ebone Monique

Fortenberry, Ebone Monique is an individual health care provider with primary practice located at 169 Walenda Dr Nw , Rome GA 30165-9730. She recently has only one registered license in Other Service Providers / Community Health Worker, which is considered as her primary health care specialty. Fortenberry, Ebone Monique can be contacted via phone (706) 314-9294.

Contact Information

Primary practice address
169 Walenda Dr Nw Rome GA 30165-9730
Phone: (706) 314-9294
Fax: (706) 314-9295
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Community Health Worker 172V00000X

Profile Details

NPI number 1609228352
LBN Legal business name Fortenberry, Ebone Monique
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 6th, 2016
Last updated Jul 6th, 2016 - about 9 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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