Jennifer Mickey Fulp, RN
Individual provider Active NPI Registered Nurse · King, NC
NPI 1689259376 · NPPES record last updated Mar 14, 2021
Key facts
- NPI
- 1689259376
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 175104 (NC)
- Practice address
- 1191 Slate Rd
King, NC 27021-8021 - Phone
- (843) 315-5234
- NPI assigned
- Mar 14, 2021
- 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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 175104 | NC | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 175104 | NC | Yes |
Addresses
Primary practice location
1191 Slate Rd
King, NC 27021-8021
Mailing address
1191 Slate Rd
King, NC 27021-8021
Phone (843) 315-5234
Other providers in King, NC
- Jamie Frazier
- Stephanie Amber Freeman
- Elizabeth Frye
- Corey Fulk
- Dixie Lynn Fulk
- Gary V. Monteith DDS PA
- Gastroenterology Associates of the Piedmont, P.a.
- Matthew J. Germini
- Rebecca J Gibson
- Tiffany Shante Gibson
All providers in King, NC · Registered Nurse in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 14, 2021. 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.