Healthcare Provider Details

I. General information

NPI: 1114835055
Provider Name (Legal Business Name): CAYLEE NICHOLE FULP APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

709 BETTER NOW PLZ
ADA OK
74820-2279
US

IV. Provider business mailing address

709 BETTER NOW PLZ
ADA OK
74820-2279
US

V. Phone/Fax

Practice location:
  • Phone: 580-310-9899
  • Fax: 580-310-9818
Mailing address:
  • Phone: 580-310-9899
  • Fax: 580-310-9818

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number200762
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: