Individual
HOLLY MAE FULMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, RN, AGPCNP-BC
Contact information
Practice address
161 FORT WASHINGTON AVE, NEW YORK, NY 10032-3729
(212) 305-7340
(212) 305-6891
Mailing address
630 W 168TH ST # 4, NEW YORK, NY 10032-3725
(212) 305-7340
(212) 305-6891
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
308196
NY
363LA2200X
Adult Health Nurse Practitioner
RN2261874
MA
Other
Enumeration date
04/23/2015
Last updated
03/17/2018
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