Fortner, Michael Scott
Fortner, Michael Scott is an individual health care provider with primary practice located at 1601 New Castle Rd , Forrest City AR 72335-2218. He recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered. Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered is his primary health care specialty. Fortner, Michael Scott can be contacted via phone (870) 261-0513.Contact Information
Primary practice address
1601 New Castle Rd
Forrest City AR 72335-2218
Phone: (870) 261-0513
Fax: (901) 261-2542
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Providers / Registered Nurse | 163W00000X | R105201 | Arkansas |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered | 367500000X | C002946 | Arkansas |
Profile Details
| NPI number | 1871595512 |
|---|---|
| LBN Legal business name | Fortner, Michael Scott |
| Credentials | Certified Registered Nurse Anesthetist (CRNA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 12th, 2005 |
| Last updated | Dec 2nd, 2019 - about 6 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 | 1871595512 | NPPES |
| Arkansas | Other | 1871595512 | WELLCARE - MEDICARE |
| Arkansas | MEDICAID | 196069001 | WELLCARE - MEDICARE |
| Arkansas | Other | 1871595512 | WELLCARE - MEDICARE |
| Arkansas | Other | 4245152 | WELLCARE - MEDICARE |
| Arkansas | Other | 1871595512 | WELLCARE - MEDICARE |
| Arkansas | Other | 1871595512 | WELLCARE - MEDICARE |
| Arkansas | Other | 1871595512 | WELLCARE - MEDICARE |
| Arkansas | Other | 1871595512 | WELLCARE - MEDICARE |
| Arkansas | Other | P00820226 | WELLCARE - MEDICARE |
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