Individual
MS. CAROL MARIE FULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
655 W 8TH ST, UFJP PEDIATRICS RAINBOW CENTER, JACKSONVILLE, FL 32209-6511
(904) 244-5248
(904) 244-5341
Mailing address
PO BOX 44008, UFJP PROVIDER ENROLLMENT, JACKSONVILLE, FL 32231-4008
(904) 244-3199
(904) 244-3425
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
ARNP1392722
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
092535513A
—
GA
05
—
3028917-00
—
FL
Enumeration date
03/12/2006
Last updated
12/16/2009
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