Doctor Name: | REGINALD FULWILEY |
NPI Number: | 1013365659 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | R857836 |
Business Practice Address: | 229 West Main St Suite 12 3rd Fl West Point, MS - 393500245 |
Business Phone Number: | 3183313619 |
Business Fax Number: | 6015109052 |
Mailing Address: | Po Box 245, PHILADELPHIA |
State: | MS |
Postal Code: | 39350 |
Phone Number: | 3183313619 |
Fax Number: | 6015109052 |
NPI Enumeration Date: | 05/24/2016 |
NPI Last Update Date: | 05/24/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 374U00000X |
License Number: | R857836 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MS |
Taxonomy Type: | Nursing Service Related Providers |
Taxonomy Classification: | Home Health Aide |
Taxonomy Specialization: | |
Taxonomy Definition: | A person trained to assist public health nurses, home health nurses, and other health professionals in the bedside care of patients in their homes. |