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1487122065
TRACEY M FORTNER
LOGANVILLE, GA
NPI
1487122065
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Professional Name
TRACEY M FORTNER
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: GA RN164997)
Enumeration Date
2018-11-13
Last Update Date
2018-11-13
Business Address
TRACEY M FORTNER FNP-BC
1103 MASON LEE AVE
LOGANVILLE, GA 30052-8635
Phone number: 678-315-7151
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Mailing Address
TRACEY M FORTNER FNP-BC
1103 MASON LEE AVE
LOGANVILLE, GA 30052-8635
Phone number: 678-315-7151
Copy
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