Jennifer J Fulmer, APRN

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

R86919 Issued in OK

Practice address

523 S Santa Fe Ave
Suite B
Edmond, OK 73003-6226

Phone

(405) 509-6777

Fax

(405) 509-6778

NPI assigned

Oct 1, 2012

Last updated

Oct 1, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1349049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349049600000",
    "number": "1235480260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "523 S SANTA FE AVE",
            "address_2": "SUITE B",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730036226",
            "telephone_number": "405-509-6777",
            "fax_number": "405-509-6778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "523 S SANTA FE AVE",
            "address_2": "SUITE B",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730036226",
            "telephone_number": "405-509-6777",
            "fax_number": "405-509-6778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULMER",
        "first_name": "JENNIFER",
        "middle_name": "J",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-01",
        "last_updated": "2012-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OK",
            "license": "R86919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Nurse Practitioner in Edmond, OK
• Providers in Edmond, OK by specialty
• Pediatric Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.