Individual
MRS. MARYANN M FULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4102 PINION DR, USAF ACADEMY, CO 80840-2502
(719) 333-5260
Mailing address
4102 PINION DR, USAF ACADEMY, CO 80840-2502
(719) 333-5260
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
APN0004350
CO
363LA2200X
Adult Health Nurse Practitioner
Primary
128222
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
22452371
—
CO
Enumeration date
04/18/2006
Last updated
07/09/2024
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