Update this page – If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS.
Individual
TAMARA ANN FULLER
Active
Individual
TAMARA ANN FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28132899A
IN
363LF0000X
Family Nurse Practitioner
Primary
71012996A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
259900048
MEDICARE
IN
05
—
300069235
—
IN
Enumeration date
07/20/2022
Last updated
11/08/2023
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