Provider Demographics
NPI:1376238956
Name:FULTON, NATALIE JUNE
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:JUNE
Last Name:FULTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11158 S LAKESHORE RD
Mailing Address - Street 2:
Mailing Address - City:CHELAN
Mailing Address - State:WA
Mailing Address - Zip Code:98816-8751
Mailing Address - Country:US
Mailing Address - Phone:509-899-1871
Mailing Address - Fax:
Practice Address - Street 1:11158 S LAKESHORE RD
Practice Address - Street 2:
Practice Address - City:CHELAN
Practice Address - State:WA
Practice Address - Zip Code:98816-8751
Practice Address - Country:US
Practice Address - Phone:509-899-1871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-10
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program