Individual provider · NPI-1

Antawaii Fulton

Home Health Aide · Newport News, VA

NPI number1124907670
StatusActive
Last updated in NPPESAug 28, 2025

Details

NPI
1124907670
Entity type
Individual (NPI-1)
Name
Mr. Antawaii Fulton
Sex
Male
Sole proprietor
No
Enumeration date
Aug 28, 2025
Certification date
Aug 28, 2025
Last updated
Aug 28, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
374U00000X Home Health Aide––Yes

Practice location

11815 Fountain Way Ste 300
Newport News, VA 23606-4448

Phone 833-711-4340

Mailing address

11815 Fountain Way Ste 300
Newport News, VA 23606-4448

Phone 833-711-4340

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