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1306190319
KELLIE JEAN FORTNER
ST AUGUSTINE, FL
NPI
1306190319
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: FL ARNP9266139)
Enumeration Date
2012-10-30
Last Update Date
2013-06-17
Business Address
-- KELLIE JEAN FORTNER A.R.N.P.
400 HEALTH PARK BLVD STE 300
ST AUGUSTINE, FL 32086-5784
Phone number: 904-819-5155
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Mailing Address
-- KELLIE JEAN FORTNER A.R.N.P.
400 HEALTH PARK BLVD STE 300
ST AUGUSTINE, FL 32086-5784
Phone number:
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