| NPI | 1467658518 |
|---|---|
| Former Name | TRICIA MAE FULLERTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH 12489-NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AR A03038) |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 3006716) | |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2023-04-11 |