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Individual

MS. SUZANNE A. FULLAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, MSN, PNP

Contact information

Practice address
669 S. HAYWOOD ST., JACKSON COUNTY PSYCHOLOGICAL SERVICES, WAYNESVILLE, NC 28786
(828) 456-2997
(828) 456-2996
Mailing address
669 S. HAYWOOD ST., JACKSON COUNTY PSYCHOLOGICAL SERVICES, WAYNESVILLE, NC 28786
(828) 456-2997
(828) 456-2996

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
300031
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7004794
NC
Enumeration date
03/29/2007
Last updated
12/28/2012
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