Individual
ANNA L FULTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71004689A
IN
363LF0000X
Family Nurse Practitioner
28106322A
IN
363LF0000X
Family Nurse Practitioner
Primary
71004689A
IN
Other
Enumeration date
10/16/2013
Last updated
03/04/2021
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