Information as of 06/22/2018

Last Updated by Licensee on 07/26/2017

Nanette Nicole Fulp PA-C
License#: 
Issue Date: 
0010-06840
10/20/2016
License Status: 
Renewal Date:
Active  
08/14/2018  
 Public Action: Yes
 See: Actions-Adverse & Administrative Tab
Licensee General Information
Active License
Reason CodeLicense NumberSubcategoryIssue DateExpire Date
 0010-06840PA-C10/20/2016 
Inactive License
Active Supervisor
SupervisorTypeStatusApproval Date
Dalton, Timothy John MDActive11/07/2016
North Carolina Hospital Admitting Privileges
Out of State Active/Inactive Licenses
None Reported
Out of Country Active/Inactive Licenses
None Reported