Jackie Fortenberry is a Jackson, Mississippi based nurse anesthetist who is specialized as Anesthesia Administration nurse. Active license number of Jackie Fortenberry is R114980 for Anesthesia Administration in Mississippi. Her current practice location is 1225 N State St, Jackson. Patients can reach her at 601-968-1362 or can fax her at 601-292-4592. Jackie Fortenberry is CRNA with specialization in Anesthesia Administration and she NPI number (Unique professional ID assigned by NPPES) is 1609902337. Jackie Fortenberry is a certified registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists.
Complete Profile:
Jackie Fortenberry speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
Specialization:
Anesthesia Administration
Credentials:
CRNA
Gender:
Female
Practice Address:
1225 N State St, Jackson, Mississippi, 39202-2064
Phone:
601-968-1362
Fax:
601-292-4592
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
NPI Number:
1609902337
NPI Enumeration Date:
26 Feb, 2007
NPI Last Update On:
08 Jul, 2007
Medical Licenses:
Nurses can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Jackie Fortenberry are as mentioned below.
License Number
Specialization
State
Status
R114980
Anesthesia Administration
Mississippi
Primary
Other Medical Identifiers:
Other legacy medical identifiers associated with Jackie Fortenberry such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
00117028
Medicaid
Mississippi
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
Po Box 23090, Jackson, Mississippi
Zip:
39225-3090
Phone Number:
601-968-1362
Fax Number:
601-292-4592
Patients can reach Jackie Fortenberry at 1225 N State St, Jackson, Mississippi or can call to book an appointment on 601-968-1362.
Comments/ Reviews:
Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 10 March, 2025.