Individual
HEATHER MARIE FULDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, FNP-BC
Contact information
Practice address
517 CENTRE VIEW BLVD, CRESTVIEW HILLS, KY 41017-3444
(859) 341-5030
(859) 578-7551
Mailing address
DEPT. 453 PO BOX 1000, MEMPHIS, TN 38148-0001
(828) 575-2625
(828) 350-2174
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3008138
KY
363LF0000X
Family Nurse Practitioner
3008138
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100261580
—
KY
01
—
K114380
MEDICARE PTAN
KY
Enumeration date
09/03/2013
Last updated
10/30/2023
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