MEDICARE: PATRICIA MARIE 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
1	163WC1500X	Community Health Registered Nurse	RN.534585	OH

General Provider Information

NPI Number	:	1902751464
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA MARIE FULTON

Provider Business Mailing Address
First Line	:	1999 FAYWOOD DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45238-3313
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1999 FAYWOOD DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45238-3313
Country	:	US
Telephone Number	:	513-368-9610
Fax Number	:

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

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/02/2026

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