Provider Demographics
NPI:1841207073
Name:FULMER, NANCY JANE (MSN, CRFNP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:JANE
Last Name:FULMER
Suffix:
Gender:F
Credentials:MSN, CRFNP
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:JANE
Other - Last Name:GRONER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3421 NIGHTINGALE DR
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-8013
Mailing Address - Country:US
Mailing Address - Phone:484-539-1350
Mailing Address - Fax:484-536-1358
Practice Address - Street 1:2151 EMRICK BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18020-8039
Practice Address - Country:US
Practice Address - Phone:610-867-3606
Practice Address - Fax:610-867-4595
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP007025B363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA50084883OtherCAPITAL BLUE CROSS