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Individual

NANCY FULMORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AGACNP-BC

Contact information

Practice address
6553 E BAYWOOD AVE STE 205, MESA, AZ 85206-1754
(480) 626-2020
(480) 626-2022
Mailing address
6622 N 91ST AVE, STE 220, GLENDALE, AZ 85305-2569
(602) 759-6883
(602) 224-3358

Taxonomy

Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
231655
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
586587
AZ
Enumeration date
09/02/2019
Last updated
12/19/2019
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