| NPI | 1487605473 |
|---|---|
| Former Name | MELISSA A FULLER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN2808682) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MT 48698) |
| Enumeration Date | 2006-05-13 |
| Last Update Date | 2023-03-22 |