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Individual
CHERYL ALLEN FULLER
Active
Individual
CHERYL ALLEN FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Taxonomy
Speciality
Code
Description
License number
State
163WW0101X
Ambulatory Women's Health Care Registered Nurse
RN186250L
PA
363L00000X
Nurse Practitioner
Primary
TP001357B
PA
363LW0102X
Women's Health Nurse Practitioner
TP001357B
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0016466420006
—
PA
05
—
0016466420007
—
PA
05
—
1007678420035
—
PA
05
—
1007678420043
—
PA
Enumeration date
10/05/2006
Last updated
02/02/2016
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