Individual
MS. MARCIA DOREEN FULLWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ANP/GNP
Contact information
Practice address
87 WATSON AVE, EAST ORANGE, NJ 07018-3303
(862) 520-2371
Mailing address
87 WATSON AVE, EAST ORANGE, NJ 07018-3303
(862) 520-2371
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F304754-1
NY
363LG0600X
Gerontology Nurse Practitioner
F340688-1
NY
Other
Enumeration date
10/25/2007
Last updated
10/25/2007
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