Provider Demographics
NPI:1962628321
Name:FULTON, SHARON MEGAN (NON HEALTH AIDE)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:MEGAN
Last Name:FULTON
Suffix:
Gender:F
Credentials:NON HEALTH AIDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6456 STATE ROUTE 784
Mailing Address - Street 2:
Mailing Address - City:SOUTH SHORE
Mailing Address - State:KY
Mailing Address - Zip Code:41175-8621
Mailing Address - Country:US
Mailing Address - Phone:606-932-6246
Mailing Address - Fax:606-932-4305
Practice Address - Street 1:6456 STATE ROUTE 784
Practice Address - Street 2:
Practice Address - City:SOUTH SHORE
Practice Address - State:KY
Practice Address - Zip Code:41175-8621
Practice Address - Country:US
Practice Address - Phone:606-932-6246
Practice Address - Fax:606-932-4305
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide