1. Home
  2. Directory
  3. Mississippi
  4. Jackson
  5. Nurse Anesthetist Certified Registered
  6. NPI Profile
Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

JACKIE FORTENBERRY CRNA
NPI 1609902337
Nurse Anesthetist, Certified Registered in Jackson, MS

Active since February 26, 2007
1225 N STATE ST, JACKSON, MS 39202(601) 968-1362(601) 292-4592 Get Directions Write a Review

NPPES record last updated: September 6, 2026. Verified against the NPPES registry weekly; last sync: September 06, 2026.

About Jackie Fortenberry Crna NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACKIE FORTENBERRY CRNA (NPI 1609902337) is an individual nurse anesthetist, certified registered in Jackson, Mississippi, licensed in Mississippi (R114980) and active in the NPI registry since February 2007.

NPPES Registry Identity

NPI1609902337
Entity TypeIndividualFemale
Primary Taxonomy367500000X
Provider Legal NameJACKIE FORTENBERRYCredential: CRNA
Location Address1225 N STATE STJackson, MS 39202-2064
Mailing AddressPo Box 23090Jackson, MS 39225-3090 · (601) 968-1362 · Fax (601) 292-4592
Phone(601) 968-1362
Fax(601) 292-4592
Sole ProprietorYes
Enumeration DateFebruary 26, 2007
Last NPPES UpdateSeptember 6, 2026
✔ NPI 1609902337 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
License✔ Licensed in MS · R114980
Definition
(1) A licensed 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. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.
1225 N STATE ST, Jackson, MS 39202
Open in Google Maps ↗

Other Identifiers 1

Medicaid00117028MS

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HADEN DAVIS
Registered Nurse
1225 N STATE ST
JACKSON, MS 39202
Hinds County (601) 968-1044
MRS. ALLISON MITCHELL CCC-SLP
Speech-Language Pathologist
1225 N STATE ST
JACKSON, MS 39202
Hinds County (601) 968-5003
STEPHEN PAUL EPPERSON MD
Family Medicine
1225 N STATE ST
JACKSON, MS 39202
Hinds County (601) 988-5281
DR. RICHARD B FRIEDMAN MD
Radiology (Radiation Oncology)
1225 N STATE ST
JACKSON, MS 39202
Hinds County (601) 968-1416
JOHN C BROOKS M.D.
Emergency Medicine (Emergency Medical Services)
1225 N STATE ST
JACKSON, MS 39202
Hinds County (601) 982-6001
KATHRYN B BROWN M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
1225 N STATE ST
JACKSON, MS 39202
Hinds County (601) 968-3070
WILLIAM FRANKLIN RAYBURN M.D.
Internal Medicine
1225 N STATE ST
JACKSON, MS 39202
Hinds County (601) 988-5281
JOSHUA GRICE CAMPBELL MD
Emergency Medicine
1225 N STATE ST
JACKSON, MS 39202
Hinds County (601) 968-1000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jackie Fortenberry's NPI number?

The NPI number for Jackie Fortenberry is 1609902337. It was assigned to this individual provider in the NPPES registry on February 26, 2007.

Where is Jackie Fortenberry located?

Jackie Fortenberry practices at 1225 N State St, Jackson, MS 39202. The listed phone number is (601) 968-1362.

What is Jackie Fortenberry's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

When was this NPI record last updated?

The NPPES record for Jackie Fortenberry was last updated on September 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.