Healthcare Provider Details

I. General information

NPI: 1356274435
Provider Name (Legal Business Name): CHERYL LORRAINE FULTZ-QUICK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 ALFRED AVE
RED SPRINGS NC
28377-7496
US

IV. Provider business mailing address

165 ALFRED AVE
RED SPRINGS NC
28377-7496
US

V. Phone/Fax

Practice location:
  • Phone: 717-303-8703
  • Fax:
Mailing address:
  • Phone: 717-303-8703
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: