Individual
DR. SUSAN A FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP, NP
Contact information
Practice address
300 MACK RD, ASHEBORO, NC 27205-1066
(336) 625-1172
(336) 625-6434
Mailing address
PO BOX 2005, ASHEBORO, NC 27204-2005
(336) 625-1172
(336) 625-6434
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
200909
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7003515
—
NC
Enumeration date
11/22/2006
Last updated
09/20/2019
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