black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

SHIRLEY B. FORTSON

PRODUCER NON-RESIDENT

License Number:
PRN478257
Status:
First Licensure:
03/07/2024
Cancel Date:
None

Mailing:
SOUTHAVEN, MS 38672
Phone:
+1 (832) 805-1296
Fax:
+1 (832) 805-1296
Email:
appointments@yourwaymedicare.com

History

License Type Start Date End Date
PRODUCER NON-RESIDENT 03/07/2024

Agency

Name Issue Date License Number Expiration Date Cancel Date
EHEALTHINSURANCE SERVICES INC
03/11/2024 AGN68778 08/06/2024

Employer

Name Issue Date License Number Expiration Date Cancel Date
ACE PROPERTY & CASUALTY INSURANCE COMPANY
06/30/2025 PCF44 08/18/2025
AMH HEALTH PLANS OF MAINE, INC.
03/07/2024 LHD353013 08/12/2024
AMH HEALTH, LLC
03/07/2024 HMD329485 08/12/2024
ANTHEM HEALTH PLANS OF MAINE INC.
03/07/2024 LHD70566 08/12/2024
ANTHEM INSURANCE COMPANIES INC
03/07/2024 LHF125537 08/12/2024
EMPIRE HEALTHCHOICE HMO, INC.
03/07/2024 HMF285382 08/12/2024
INSURANCE COMPANY OF NORTH AMERICA
08/18/2025 PCF480

Authority

Description Issue Date Termination Date Status
HEALTH 03/07/2024 Active

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
15722159

Other Addresses

Address Type
SOUTHAVEN, MS 38672
Office

An active license/permit may still be subject to limitations and restrictions as a result of disciplinary action imposed. Please contact the specific licensing board about specific disciplinary actions.

Date: 02/01/2026 04:05:58 AM