Provider Demographics
NPI:1093515983
Name:FORTIER, EMILY (CNM)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:FORTIER
Suffix:
Gender:
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 N RURAL RD APT 2073
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-6097
Mailing Address - Country:US
Mailing Address - Phone:715-360-2850
Mailing Address - Fax:
Practice Address - Street 1:2545 W FRYE RD STE 9
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-6273
Practice Address - Country:US
Practice Address - Phone:480-505-4258
Practice Address - Fax:480-505-3689
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ250326176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife