Individual
WANDA KAY FULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
3041 OLD EASTOVER RD, EASTOVER, SC 29044-8303
(803) 353-8741
(803) 353-8789
Mailing address
9023 GARNERS FERRY RD, HOPKINS, SC 29061-9540
(803) 978-1848
(803) 978-1852
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
24237
SC
Other
Enumeration date
08/04/2020
Last updated
11/06/2020
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