| Doctor Name: | MS. MELANIE STOVALL FORTENBERRY |
| NPI Number: | 1487853990 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | RN164301 |
| Business Practice Address: | 1078 Lumpkin Campground Rd S Ste 100 Dawsonville, GA - 305340988 |
| Business Phone Number: | 7062658441 |
| Business Fax Number: | 7062658442 |
| Mailing Address: | Po Box 1449, DAHLONEGA |
| State: | GA |
| Postal Code: | 305330025 |
| Phone Number: | 7062658441 |
| Fax Number: | 7062658442 |
| NPI Enumeration Date: | 07/13/2007 |
| NPI Last Update Date: | 12/11/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | RN164301 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |