Individual
JUSTIN FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
70 PLAZA DR, PELL CITY, AL 35125-9314
(205) 814-9284
(205) 814-9626
Mailing address
70 PLAZA DR, PELL CITY, AL 35125-9314
(205) 814-9284
(205) 814-9626
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-131835
AL
Other
Enumeration date
08/28/2019
Last updated
08/28/2019
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