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Individual
MS. TEAWKA FULLMORE
Active
Individual
MS. TEAWKA FULLMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN176193
GA
363LF0000X
Family Nurse Practitioner
Primary
RN176193
GA
363LG0600X
Gerontology Nurse Practitioner
RN176193
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1144420530
MEDICARE GROUP NPI
GA
01
—
1861884215
MEDICARE NPI
GA
01
—
2025I01375
MEDICARE PTAN
GA
01
—
CG6045
RAILROAD MEDICARE GROUP ID
GA
01
—
RN176193
RN STATE LICENSE
—
Enumeration date
02/23/2015
Last updated
10/13/2025
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