Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Jeannine Marie Fortin, MD

Individual provider Family Medicine Physician · NPI 1174556450

Dr. Jeannine Marie Fortin, MD is a Family Practice in Seymour, Wisconsin. Graduated from University of Manitoba, Faculty of Medicine in 1985, 41 years ago. Practices with Cleanslate Medical Group of Wisconsin SC, a 28-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
41
Trained at
University of Manitoba, Faculty of Medicine
Licensed in
WI
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1100 Orchard Dr
Seymour, WI 54165-1600
Phone: (920) 833-5100
Fax: (920) 833-5100
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 46699 (WI)

Record details

NPI number1174556450
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 9, 2006
Last updated in NPPESSeptember 11, 2012

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Also practisesPERIPHERAL VASCULAR DISEASE
Medical schoolUNIVERSITY OF MANITOBA, FACULTY OF MEDICINE
Graduated 1985 (41 years in practice)
Group practice Cleanslate Medical Group Of Wisconsin Sc — 28 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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