Kimberley Fulton

Individual provider Active NPI Licensed Practical Nurse · Trotwood, OH

NPI 1831453554 · NPPES record last updated Jun 30, 2012

Key facts

NPI
1831453554
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
138188 (OH)
Practice address
360 Burman Ave
Trotwood, OH 45426-2716
Phone
(937) 397-9868
NPI assigned
Jun 27, 2012
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

State licenses

LicenseStateTypeSpecialty
138188OHMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 138188 OH Yes

Addresses

Primary practice location

360 Burman Ave
Trotwood, OH 45426-2716

Mailing address

360 Burman Ave
Trotwood, OH 45426-2716
Phone (937) 397-9868

Other providers in Trotwood, OH

All providers in Trotwood, OH · Licensed Practical Nurse in Ohio

Sources for this page

Verify at the official NPI Registry.