Provider Demographics
NPI:1164111969
Name:FULCHER, ASHLEY NORA (NP)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:NORA
Last Name:FULCHER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:ASHLEY
Other - Middle Name:NORA
Other - Last Name:BRISTOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1751 WALLACE BLVD
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-1711
Mailing Address - Country:US
Mailing Address - Phone:806-212-4673
Mailing Address - Fax:
Practice Address - Street 1:1751 WALLACE BLVD
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1711
Practice Address - Country:US
Practice Address - Phone:806-212-4673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-05
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1114707363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily