Provider Demographics
NPI:1770722373
Name:FULGER, JULIE KAY (RN)
Entity type:Individual
Prefix:MS
First Name:JULIE
Middle Name:KAY
Last Name:FULGER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:JULIE
Other - Middle Name:KAY
Other - Last Name:BLOMQUIST
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3 BRIARFIELD DRIVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-0000
Mailing Address - Country:US
Mailing Address - Phone:518-383-6828
Mailing Address - Fax:
Practice Address - Street 1:3 BRIARFIELD DRIVE
Practice Address - Street 2:
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065-0000
Practice Address - Country:US
Practice Address - Phone:518-383-6828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-05
Last Update Date:2009-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY434606-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse