| NPI | 1871251702 |
|---|---|
| Former Name | STEPHANIE MARIE FULTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NH 079750-23) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: NH 079750-23) |
| Enumeration Date | 2021-12-08 |
| Last Update Date | 2022-02-25 |