Individual
FREIDA FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3001 MERCER UNIVERSITY DR, ATLANTA, GA 30341-4115
(678) 547-6742
Mailing address
3457 ROSE ARBOR CT, ATLANTA, GA 30340-4038
(770) 856-2135
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
104781
GA
Other
Enumeration date
07/23/2013
Last updated
07/23/2013
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