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Individual

MELISSA KAYE FULTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
1760 COUNTY ROAD J, WAHOO, NE 68066-4152
(402) 443-4191
(402) 443-1451
Mailing address
1760 COUNTY ROAD J, WAHOO, NE 68066-4152
(402) 443-4191
(402) 443-1451

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
110638
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1900421
UNITED HEALTH CARE
01
242362
MIDLANDS CHOICE
01
37339
BLUE CROSS BLUE SHIELD
01
P00159345
RR MEDICARE
Enumeration date
07/07/2006
Last updated
12/16/2016
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