Anna L Fultz, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71004689A Issued in IN

Practice address

2 Bisbee St
Lisbon, ME 04250-6835

Phone

(207) 353-6721

NPI assigned

Oct 16, 2013

Last updated

Mar 4, 2021By 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 3

Addresses

Other names 1

• Anna L Fultz Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/4517c430-03bf-4e32-b324-1387cc4e73f3/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Central Maine Medical Center

  dba CMMC Specialty Pharmacy

  • Community/Retail Pharmacy
  • Lewiston, ME
  • NPI 1033874458
  NPD (past)

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

{
    "created_epoch": "1381881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1306274014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 LOWELL ST",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042407639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 BISBEE ST",
            "city": "LISBON",
            "state": "ME",
            "postal_code": "042506835",
            "telephone_number": "207-353-6721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULTZ",
        "first_name": "ANNA",
        "middle_name": "L",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-16",
        "last_updated": "2021-03-04",
        "certification_date": "2021-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71004689A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28106322A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71004689A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNA",
            "last_name": "FULTZ",
            "middle_name": "L",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Farwell Associates
• Daniel M Figueiredo, DMD
• Jensin Maxine Fish, MS-SLP
• Nakea M Fournier, INHC
• Henry Fuller III, MASTER OF SCIENCE OT
• Mariette Marie Hanlon, LCSW
• Heartful Homes Care LLC
• Inspire Well LLC
• Katelyn Jacques, CCC-SLP
• Lisbon Emergency Inc

• Family Nurse Practitioner in Lisbon, ME
• Providers in Lisbon, ME by specialty
• Family Nurse Practitioner in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2021; 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.