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Individual

MICHELLE ANN NULTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
169 RIVERSIDE DR, SUITE 307, BINGHAMTON, NY 13905-4246
(607) 798-5897
Mailing address
169 RIVERSIDE DR, SUITE 307, BINGHAMTON, NY 13905-4246
(607) 798-5897

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3315961
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01790367
NY
Enumeration date
11/03/2005
Last updated
03/06/2012
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