MEDICARE: NANCY JANE FULMER MSN, CRFNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	SP007025B	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	50084883	OTHER	PA	CAPITAL BLUE CROSS

General Provider Information

NPI Number	:	1841207073
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY JANE FULMER MSN, CRFNP

Provider Business Mailing Address
First Line	:	3421 NIGHTINGALE DR
Second Line	:
City	:	EASTON
State	:	PA
Zip	:	18045-8013
Country	:	US
Telephone Number	:	484-539-1350
Fax Number	:	484-536-1358

Provider Business Practice Location Address
First Line	:	292 FRANTZ RD STE 108
Second Line	:
City	:	STROUDSBURG
State	:	PA
Zip	:	18360-6205
Country	:	US
Telephone Number	:	570-476-3336
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2006
Last Update Date	:	06/08/2026

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