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General NPI Number Information
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NPI Number | 1144630047
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Entity Type | Individual
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Provider Name | MELISSA A FULTON CNP
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Gender | Female
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Dates
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Enumeration Date | 04/30/2014
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Last Update Date | 01/14/2019
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Provider Practice Location Address
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Address Line | 6507 HARRISON AVE UNIT N
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City | CINCINNATI
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State | OH
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Zip | 45247-2815
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Country | US
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Telephone | 513-981-4242
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Fax | 513-347-5050
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Provider Business Mailing Address
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Address Line | 6507 HARRISON AVE UNIT N
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City | CINCINNATI
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State | OH
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Zip | 45247-2815
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Country | US
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Telephone | 513-981-4242
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Fax | 513-347-5050
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 3008621
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | COA.15660-NP
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3008621
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License Number State | KY
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | COA.15660-NP
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License Number State | OH
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN.CNP.15660
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License Number State | OH
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