Provider Demographics
NPI:1720117070
Name:FULTON DUNN, JODI LYN (MSN, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:JODI
Middle Name:LYN
Last Name:FULTON DUNN
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Gender:F
Credentials:MSN, FNP-BC
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Mailing Address - Street 1:4371 VERONICA S SHOEMAKER BLVD
Mailing Address - Street 2:ATTN: CREDENTIALING
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33916-2216
Mailing Address - Country:US
Mailing Address - Phone:239-274-8200
Mailing Address - Fax:239-278-3500
Practice Address - Street 1:9776 BONITA BEACH RD SE
Practice Address - Street 2:SUITE 201A
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34135-4773
Practice Address - Country:US
Practice Address - Phone:239-947-3092
Practice Address - Fax:239-947-1077
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2014-09-12
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Provider Licenses
StateLicense IDTaxonomies
NYF334546363LF0000X
FLARNP 9311614363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily