Provider Demographics
NPI:1447074174
Name:FULKERSON, MARGARET (FNP-C)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:FULKERSON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 S SIXTH ST
Mailing Address - Street 2:
Mailing Address - City:BAY SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39422-9055
Mailing Address - Country:US
Mailing Address - Phone:601-764-4501
Mailing Address - Fax:
Practice Address - Street 1:20 S SIXTH ST
Practice Address - Street 2:
Practice Address - City:BAY SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39422-9055
Practice Address - Country:US
Practice Address - Phone:601-764-4501
Practice Address - Fax:601-764-2301
Is Sole Proprietor?:No
Enumeration Date:2024-11-11
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS907761363LF0000X
MS888860163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse