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Individual

SUSAN FULLERTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSN

Contact information

Practice address
4923 OGLETOWN STANTON RD, SUITE 200, NEWARK, DE 19713-2081
(302) 225-0451
(302) 225-0472
Mailing address
4923 OGLETOWN STANTON RD, SUITE 200, NEWARK, DE 19713-2081
(302) 225-0451
(302) 225-0472

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AC000097
MD
363L00000X
Nurse Practitioner
Primary
LG0000136
DE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0046973
NJ
05
1000024659
DE
05
404275100
MD
Enumeration date
10/05/2005
Last updated
06/15/2011
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