# MRS. KIMBERLY FULLER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1083860324
- **Gender:** F
- **Credential:** MSN, ACNP - BS

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207P00000X | Emergency Medicine Physician | R853474 | MS | — |
| 363LA2100X | Acute Care Nurse Practitioner | R853474 | MS | Yes |

## Other

- **Enumeration date:** 08/18/2008
- **Last updated:** 03/16/2009