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Individual

ERINN C FULLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
3221 BEACON PARKWAY, GRANGER, IN 46530-7196
(574) 647-1670
(574) 647-6927
Mailing address
3245 HEALTH DR STE 100, GRANGER, IN 46530-1380
(574) 647-2129
(574) 237-6069

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10001520A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300005961
IN
Enumeration date
03/11/2010
Last updated
09/17/2025
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