Healthcare Provider Details

I. General information

NPI: 1841207073
Provider Name (Legal Business Name): NANCY JANE FULMER MSN, CRFNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NANCY JANE GRONER

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

292 FRANTZ RD STE 108
STROUDSBURG PA
18360-6205
US

IV. Provider business mailing address

3421 NIGHTINGALE DR
EASTON PA
18045-8013
US

V. Phone/Fax

Practice location:
  • Phone: 570-476-3336
  • Fax:
Mailing address:
  • Phone: 484-539-1350
  • Fax: 484-536-1358

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP007025B
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: