Amber Fortin, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

305959 Issued in NY

Practice address

263 Blue Point Ave
Blue Point, NY 11715-1224

Phone

(631) 419-6737

NPI assigned

Jul 11, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1341964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341964800000",
    "number": "1861757122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 VAUTRIN AVE",
            "city": "HOLTSVILLE",
            "state": "NY",
            "postal_code": "117421624",
            "telephone_number": "631-960-6124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 BLUE POINT AVE",
            "city": "BLUE POINT",
            "state": "NY",
            "postal_code": "117151224",
            "telephone_number": "631-419-6737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTIN",
        "first_name": "AMBER",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-11",
        "last_updated": "2012-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "305959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Winnifred Cynthia Fast, RN
• Nacole Marie Fatigate, M.A., CCC-SLP
• Shakira Felder, LPN
• Melissa Ficken
• Danielle Flora
• Ilene Fox, LMT
• Janez Francis
• Stefanie Anne Gambino, LMT
• Breanna Nyiema Gambrell
• Julissa Garcia

• Licensed Practical Nurse in Blue Point, NY
• Providers in Blue Point, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.