Keturah Fulton
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Enon, OH
NPI 1154872398 · NPPES record last updated Oct 24, 2016
Key facts
- NPI
- 1154872398
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 5201 W Jackson Rd
Enon, OH 45323-9783 - Phone
- (937) 543-8663
- NPI assigned
- Oct 24, 2016
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
5201 W Jackson Rd
Enon, OH 45323-9783
Mailing address
5201 W Jackson Rd
Enon, OH 45323-9783
Phone (937) 543-8663
Other providers in Enon, OH
- Divine Intervention Recovery Center, LLC
- Brenda Lee Driscoll
- Ernst F. Fischer O.D., Inc.
- Ferguson Chiropractic Solutions
- Ferguson Chiropractic Solutions LLC
- Amanda Irene Fultz
- Greenon Local School District
- Kristen M Grimm
- Macey Marie Hardy
- Pamela Helton
All providers in Enon, OH · Student in an Organized Health Care Education/Training Program in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 24, 2016. 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.