Individual
TRACY LYNN FULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
269 PORTLAND WAY S, GALION, OH 44833-2312
(419) 468-4841
Mailing address
701 TECH CENTER DR STE 250, GAHANNA, OH 43230-1987
(614) 944-4800
(614) 944-4750
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN.CNP.021791
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0180847
—
OH
Enumeration date
11/30/2017
Last updated
12/29/2020
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