Healthcare Provider Details
I. General information
NPI: 1285596767
Provider Name (Legal Business Name): ASHLEY FULTON IHP, BCP3
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 12/02/2025
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
98 GRANT ST S STE B
BONDURANT IA
50035-2001
US
IV. Provider business mailing address
914 SE KENSINGTON RD
ANKENY IA
50021-3959
US
V. Phone/Fax
- Phone: 515-229-3198
- Fax:
- Phone: 515-229-3198
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171400000X |
| Taxonomy | Health & Wellness Coach |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: