Individual
AMANDA ELIZABETH SALLE FULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
11402 ANDERSON RD, SUITE A, GREENVILLE, SC 29611-7557
(864) 631-2799
(864) 522-1215
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
20332
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP3992
—
SC
Enumeration date
07/08/2016
Last updated
02/10/2023
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