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NPI Code Detail

MEDICARE: RAEGAN FULTON

MEDICARE: RAEGAN FULTON
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
1225X00000XOccupational Therapist6201OK

General Provider Information

NPI Number : 1831048735
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAEGAN FULTON
Provider Business Mailing Address
First Line : 7608 E 91ST ST
Second Line :
City : TULSA
State : OK
Zip : 74133-6014
Country : US
Telephone Number : 918-663-0606
Fax Number :
Provider Business Practice Location Address
First Line : 7608 E 91ST ST
Second Line :
City : TULSA
State : OK
Zip : 74133-6014
Country : US
Telephone Number : 918-663-0606
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2026
Last Update Date : 01/23/2026

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Directions to “ RAEGAN FULTON ” Practice Location

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