MEDICARE: MRS. ANNA FAUCHER FULTON RNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN22114	RI
2	363LA2200X	Adult Health Nurse Practitioner	NPP22114	RI

General Provider Information

NPI Number	:	1407059538
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANNA FAUCHER FULTON RNP

Provider Business Mailing Address
First Line	:	1681 CRANSTON ST
Second Line	:
City	:	CRANSTON
State	:	RI
Zip	:	02920-5000
Country	:	US
Telephone Number	:	401-946-8446
Fax Number	:	401-946-8340

Provider Business Practice Location Address
First Line	:	1681 CRANSTON ST
Second Line	:
City	:	CRANSTON
State	:	RI
Zip	:	02920-5000
Country	:	US
Telephone Number	:	401-946-8446
Fax Number	:	401-946-8340

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2007
Last Update Date	:	09/11/2025

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