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AMANDA MICHELLE FULMER

>> Registered Nurse >> Nursing Service Providers

Registrant NPI Number: 1558710616

Individual Registrant:
 AMANDA MICHELLE FULMER 
Gender: F
Not Sole Proprietor

Location and contact information for practice:
559 VINCENT STREET 21 MDOS/SGOG-ATTN: WOMEN'S HEALTH PETERSON AFB, CO 80914-1540 US
Tel: 719-556-0610  Fax: 877-813-1756

Contact information for business:
559 VINCENT STREET 21 MDOS/SGOG-ATTN: WOMEN'S HEALTH PETERSON AFB, CO 80914-1540 US
Tel: 719-556-0610  Fax: 877-813-1756

Registration Information:
NPI: 1558710616
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N163W00000XNursing Service Providers
Registered Nurse
MDR172250
Y363LW0102XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
VA0024173165

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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