Individual
AVERIE CAROLINE FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
175 WHITE ST NW, MARIETTA, GA 30060-1053
(470) 793-0200
Mailing address
1808 BAYNARD CT NW, ACWORTH, GA 30102-6463
(770) 617-8483
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN290105
GA
Other
Enumeration date
08/04/2025
Last updated
08/04/2025
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