Ms Amanda Irene Fultz, is a
Licensed Practical Nurse based in Enon, Ohio. Ms Amanda Irene Fultz is licensed to practice in Ohio (license number PN. 128204 IV) and her current practice location is
6654 New Horizon Ave, Enon, Ohio. She can be reached at her office (for appointments etc.) via phone at
(937) 450-5811.
NPI number for Ms Amanda Irene Fultz is 1609161389 and her current mailing address is 6654 New Horizon Ave, Enon, Ohio. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1609161389.
Provider's Profile
| Full Name | Ms Amanda Irene Fultz |
|---|
| Gender | Female |
|---|
| Speciality | Licensed Practical Nurse |
|---|
| Location | 6654 New Horizon Ave, Enon, Ohio |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1609161389
- Provider Enumeration Date: 06/10/2011
- Last Update Date: 06/10/2011
Medical Identifiers
Medical identifiers for Ms Amanda Irene Fultz such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1609161389 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 164W00000X | Licensed Practical Nurse | PN. 128204 IV (Ohio) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Amanda Irene Fultz is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Ms Amanda Irene Fultz,
6654 New Horizon Ave,
Enon, OH 45323-1450
Ph: (937) 450-5811 | Ms Amanda Irene Fultz,
6654 New Horizon Ave,
Enon, OH 45323-1450
Ph: (937) 450-5811 |
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