Individual
REBECCA FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
201 EAST STATE ST, MEDICAL ARTS BUILDING, HERKIMER, NY 13350
(315) 574-2300
(315) 574-2310
Mailing address
111 HOSPITAL DR, UTICA, NY 13502-2517
(315) 624-6100
(315) 801-8391
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
752162
NY
363L00000X
Nurse Practitioner
Primary
355036
NY
Other
Enumeration date
06/07/2022
Last updated
05/28/2026
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