Fulkerson, Nina Michael

Fulkerson, Nina Michael is an individual health care provider with primary practice located at 2360 Stony Brook Dr , Louisville KY 40220-4018. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Fulkerson, Nina Michael can be contacted via phone (502) 446-5462.

Contact Information

Primary practice address
2360 Stony Brook Dr Louisville KY 40220-4018
Phone: (502) 446-5462
Fax: (502) 394-3670
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 3003622 Kentucky

Profile Details

NPI number 1134123649
LBN Legal business name Fulkerson, Nina Michael
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2005
Last updated Oct 16th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134123649 NPPES
Kentucky MEDICAID 7100005460

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