Individual
DOROTHY L FULLEX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, NP-C
Contact information
Practice address
1120B 2ND AVE S, NORTH MYRTLE BEACH, SC 29582-3108
(843) 366-2714
(843) 366-2455
Mailing address
1018 2ND AVE S, NORTH MYRTLE BEACH, SC 29582-3573
(843) 366-2714
(843) 366-2455
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
20234
SC
363LX0106X
Occupational Health Nurse Practitioner
Primary
20234
SC
Other
Enumeration date
05/26/2016
Last updated
08/17/2021
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