Individual provider · Type 1 NPI

Justin L. Mortensen

Student in an Organized Health Care Education/Training Program · Fort Eisenhower, GA

NPI number 1376333872 Active

Practice location

201 3rd Ave Bldg 38200, Pmb 216
Fort Eisenhower, GA 30905

Call (414) 573-1502 Map

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1376333872

Justin L. Mortensen's National Provider Identifier is 1376333872, issued on May 8, 2025. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Fort Eisenhower, GA. The record was last updated on May 8, 2025.