Individual
MRS. ASHLEY LEDFORD FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Contact information
Practice address
3980 HIGHWAY 100, GREENVILLE, GA 30222-2109
(706) 302-3149
Mailing address
3980 HIGHWAY 100, GREENVILLE, GA 30222-2109
(706) 302-3149
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
20080140
GA
Other
Enumeration date
03/13/2008
Last updated
03/13/2008
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