KELLIE JEAN FORTNER A.R.N.P. NPI 1306190319

NPI Information

  • NPI: 1306190319
  • Provider Name: KELLIE JEAN FORTNER, A.R.N.P.
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • Address: 400 HEALTH PARK BLVD
    STE 300
    ST AUGUSTINE, FL
    ZIP 32086
  • Phone: (904) 819-5155

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NPI Details

Kellie Jean Fortner, A.R.N.P. is a family nurse practitioner in St Augustine, FL. Kellie Jean Fortner, A.R.N.P. NPI is 1306190319. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

400 HEALTH PARK BLVD
STE 300
ST AUGUSTINE, FL
ZIP 32086-784
Phone: (904) 819-5155

The enumeration date for this NPI number is 10/30/2012 and was last updated on 6/17/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamilyARNP9266139FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1P01160791OTHERFLORIDARAILROAD
2008049800MEDICAIDFLORIDA
3GY177ZMEDICARE PINFLORIDA
4Y0F42OTHERFLORIDABCBS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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