Individual
TERESA FULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN, RN
Contact information
Practice address
7229 NIGHTSTALKER WAY, FT CAMPBELL, KY 42223
(270) 461-3861
(270) 798-1118
Mailing address
7229 NIGHTSTALKER WAY, FT CAMPBELL, KY 42223
(270) 461-3861
(270) 798-1118
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
RN613887
PA
163WC0400X
Case Management Registered Nurse
RN613887
PA
163WP2201X
Ambulatory Care Registered Nurse
Primary
RN613887
PA
Other
Enumeration date
06/01/2023
Last updated
06/01/2023
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