Individual
CHRISTIE JO FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1033 DR MARTIN LUTHER KING JR ST N, SUITE 108, ST PETERSBURG, FL 33701-1547
(727) 456-3288
(727) 346-1044
Mailing address
1033 DR MARTIN LUTHER KING JR ST N, SUITE 108, ST PETERSBURG, FL 33701-1547
(727) 456-3288
(727) 346-1044
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
ARNP9203862
ZZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ARNP9203862
FL LICENSE
FL
Enumeration date
07/24/2009
Last updated
07/24/2009
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