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Tara C Fulk
Specialist in Bridgewater, Virginia
NPI 1427047026

Tara C Fulk is a Specialist based in Bridgewater, VA. Tara C Fulk practices in Bridgewater, VA. The NPI Number for Tara C Fulk is 1427047026 and holds a License No. 2305202825 (Virginia).

The current practice location address for Tara C Fulk is 112 N River Rd, Bridgewater, VA and can be reached out via phone at 540-828-6443 and via fax at 540-828-6583.

Location: 112 N River Rd, Bridgewater, VA, 22812-1611
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1427047026
Provider Name
Tara C Fulk
Credential
Provider Entity Type
Individual
Gender
Female
Address
112 N River Rd, Bridgewater, VA, 22812-1611
Phone Number
540-828-6443
Fax Number
540-828-6583
Provider Enumeration Date
10/17/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
194031 01 VA ANTHEM PROVIDER NUMBER
institution
Provider Business Practice Location Address Details
Address
112 N River Rd
City
Bridgewater
State
Virginia
Zip
22812-1611
Phone Number
540-828-6443
Fax Number
540-828-6583
person
Provider Business Mailing Address Details
Address
112 N River Rd
City
Bridgewater
State
Virginia
Zip
22812-1611
Phone Number
540-828-6443
Fax Number
540-828-6583
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
2305202825 (Virginia)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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