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Individual
DOROTHY JANE FULLER
Active
Individual
DOROTHY JANE FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
135163
CA
363LP0200X
Pediatric Nurse Practitioner
Primary
312
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M0274138
DRIVER LICENSE
CA
Enumeration date
08/15/2006
Last updated
09/11/2025
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