NPI | 1184860983 |
---|---|
Former Name | AMANDA FULLERTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NV 825927) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: WA AP61623307) |
363LA2200X Nurse Practitioner, Adult Health (Licence: OR 201404840NP-PP) | |
363LA2200X Nurse Practitioner, Adult Health (Licence: TN APN13902) | |
Enumeration Date | 2008-12-29 |
Last Update Date | 2024-12-16 |