Willimae Fulton
Individual provider Active NPI Social Worker · Wiggins, MS
NPI 1124836721 · NPPES record last updated Dec 28, 2024
Key facts
- NPI
- 1124836721
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- M10605 (MS)
- Practice address
- 255 Newco Rd
Wiggins, MS 39577-8938 - Phone
- (512) 665-2382
- NPI assigned
- Dec 28, 2024
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M10605 | MS | MD | Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | M10605 | MS | Yes |
Addresses
Primary practice location
255 Newco Rd
Wiggins, MS 39577-8938
Mailing address
255 Newco Rd
Wiggins, MS 39577-8938
Phone (512) 665-2382
Other providers in Wiggins, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 28, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.