Individual provider · Type 1 NPI
Gloria McCann Fortune, NP
Psychiatric/Mental Health Nurse Practitioner · Port Jefferson, NY
NPI number
1952447005
Active
Practice location
75 N Country Rd
Port Jefferson, NY 11777-2119
Fax (631) 473-3091
Mailing address
625 Belle Terre Rd, Suite 100
Port Jefferson, NY 11777-2316
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 400369 (NY) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1952447005
Gloria McCann Fortune, NP's National Provider Identifier is 1952447005, issued on Jan 29, 2007. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Port Jefferson, NY. The record was last updated on Apr 30, 2015.