Individual
AMBER AMELIA FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
8303 DODGE ST, OMAHA, NE 68114-4108
(402) 354-4000
(402) 354-8469
Mailing address
PO BOX 2797, OMAHA, NE 68103-2797
(402) 354-4230
(402) 354-6171
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
112367
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1346753464
—
IA
05
—
47037660432
—
NE
Enumeration date
11/11/2017
Last updated
03/05/2018
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