Most Relevant Information
Provider Data
| NPI Number: | 1003653163 |
| Provider Name: | SAMANTHA A FULSE |
| Entity Type: | Individual |
| Taxonomy Code: | 374U00000X |
| Specialty: | Home Health Aide |
| License Number: | CN0028905888 |
Most Important Dates
| Enumeration Date: | 07/15/2024 |
| Last Updated: | 07/15/2024 |
Provider Practice Location
97109 PIRATES POINT RD
YULEE
FL
320976533
Practice Location Phone/Fax
| Phone: | 9049011718 |
| Fax: |
Provider Mailing Location
201 J NOLAN WELLS RD APT E306
KINGSLAND
GA
315486854
Provider Mailing Phone/Fax
| Phone: | 9042508491 |
| Fax: |