Individual
BEATRICE LYNNE FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2250 HICKORY RD, SUITE 240, PLYMOUTH MEETING, PA 19462-1047
(610) 834-1122
(610) 834-7525
Mailing address
1136 BAINBRIDGE ST, PHILADELPHIA, PA 19147-1909
(267) 886-9367
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
PN5157986
FL
164W00000X
Licensed Practical Nurse
TLPN003944
PA
164X00000X
Licensed Vocational Nurse
Primary
205047
TX
Other
Enumeration date
05/09/2007
Last updated
09/11/2025
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