Individual
COURTNEY LYNN FULLMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
1130 N J ST, RICHMOND, IN 47374-1913
(659) 833-2987
Mailing address
1100 REID PKWY, RICHMOND, IN 47374-1157
(765) 935-8802
(765) 983-3219
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
28176654A
IN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
71011620A
IN
Other
Enumeration date
04/20/2021
Last updated
09/11/2024
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