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Individual
STEPHANIE FULLER
Active
Individual
STEPHANIE FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4009615
KY
363L00000X
Nurse Practitioner
71006152A
IN
363LF0000X
Family Nurse Practitioner
Primary
71006152A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
71006152A
LICENSE
IN
Enumeration date
03/23/2016
Last updated
11/10/2023
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