Individual
JUDITH ANN FULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
130 WAYNE FRYE DR, MANCHESTER, OH 45144-9314
(937) 549-1270
(937) 549-1286
Mailing address
14575 STATE ROUTE 41, WEST UNION, OH 45693-9744
(937) 544-2269
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN.CNP.020752
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0249089
—
OH
Enumeration date
06/28/2017
Last updated
02/14/2022
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