# MRS. TYRA FULCHER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1922292804
- **Gender:** F
- **Credential:** RN, PHN, CCM

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163W00000X | Registered Nurse | 659665 | CA | — |
| 171M00000X | Case Manager/Care Coordinator | 69358 | CA | — |
| 171M00000X | Case Manager/Care Coordinator | 979742 | TX | Yes |

## Other

- **Enumeration date:** 09/04/2007
- **Last updated:** 04/08/2025