Individual
AMANDA M FULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4215 S 20TH ST, OMAHA, NE 68107-2018
(531) 299-2100
Mailing address
3215 CUMING ST, OMAHA, NE 68131-2000
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
61151
NE
Other
Enumeration date
08/03/2022
Last updated
08/03/2022
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