Individual
KERI ROSE FULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
620 HOWARD AVE, ALTOONA, PA 16601-4804
(814) 889-2011
Mailing address
2527 BROAD AVE APT 1, ALTOONA, PA 16601-1912
(724) 599-9091
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP022438
PA
Other
Enumeration date
10/10/2020
Last updated
01/30/2024
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