Individual
JANE ELIZABETH MERIE FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1215 E CHAPMAN AVE, ORANGE, CA 92866-2237
(714) 516-9045
(714) 516-9860
Mailing address
1215 E CHAPMAN AVE, ORANGE, CA 92866-2237
(714) 516-9045
(714) 516-9860
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
792747
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
330150193
MEDICAL
CA
Enumeration date
10/23/2014
Last updated
10/23/2014
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