Rebecca Lu Fultz, RN
Individual provider Active NPI Case Management Registered Nurse · Dresser, WI
NPI 1982861944 · NPPES record last updated May 23, 2011
Key facts
- NPI
- 1982861944
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Management Registered Nurse 163WC0400X
- License
- 174688-030 (WI)
- Practice address
- 1848 93Rd Ave Apt C
Dresser, WI 54009-4627 - Phone
- (171) 555-4204
- NPI assigned
- May 19, 2008
- 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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 174688-030 | WI | MD | Case Management Registered Nurse |
| 306538-031 | WI | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 306538-031 | WI | |
| Case Management Registered Nurse | 163WC0400X | 174688-030 | WI | Yes |
Addresses
Primary practice location
1848 93Rd Ave Apt C
Dresser, WI 54009-4627
Mailing address
1848 93Rd Ave Apt C
Dresser, WI 54009-4627
Phone (171) 555-4204
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3950845470 | Medicaid | WI |
Other providers in Dresser, WI
- Jeanette Boissy
- Grounded Living Ecotherapy Services LLC
- Suzanne Patricia Ingebrigtson
- Linda S Leef
- Sheena G Malm
- Northern Bridges
All providers in Dresser, WI · Case Management Registered Nurse in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 23, 2011. 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.