Individual
REBECCA FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, BSN, RN
Contact information
Practice address
11948 BALM RIVERVIEW RD, RIVERVIEW, FL 33569-6601
(813) 236-9000
Mailing address
2476 CORONADO WAY, DUNEDIN, FL 34698-2033
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
APRN11042771
FL
Other
Enumeration date
08/06/2024
Last updated
11/11/2025
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