| NPI | 1427289222 |
|---|---|
| Former Name | JESSICA MARY FULTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN 1296) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R-164801-8) |
| Enumeration Date | 2009-07-29 |
| Last Update Date | 2025-05-01 |