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Individual

SETH FILLMORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP

Contact information

Practice address
9040A JACKSON AVE, JOINT BASE LEWIS MCCHORD, WA 98431-4712
(253) 968-0770
Mailing address
4301 JONES BRIDGE RD, BETHESDA, MD 20814-4712

Taxonomy

Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
7658791-3102
UT
363LF0000X
Family Nurse Practitioner
Primary
7658791-8900
UT

Other

Enumeration date
10/27/2020
Last updated
09/04/2024
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