Rae Fulton, Stephanie Elizabeth

Rae Fulton, Stephanie Elizabeth is an individual health care provider with primary practice located at 4800 Highland Rd , Waterford MI 48328-1176. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Rae Fulton, Stephanie Elizabeth can be contacted via phone (248) 673-0500.

Contact Information

Primary practice address
4800 Highland Rd Waterford MI 48328-1176
Phone: (248) 673-0500
Fax: (248) 673-6077
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 5601006793 Michigan

Profile Details

NPI number 1396177556
LBN Legal business name Rae Fulton, Stephanie Elizabeth
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 30th, 2013
Last updated Oct 5th, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396177556 NPPES
Michigan Other 5601006793 LICENSE#

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