Individual
MRS. LINDA DIANE FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1900 SUNRISE DR STE 200, SAINT PETER, MN 56082-5385
(507) 665-6299
Mailing address
PO BOX 860075, MINNEAPOLIS, MN 55486-0075
(507) 665-6299
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
6109
MN
363L00000X
Nurse Practitioner
A152724
IA
363LF0000X
Family Nurse Practitioner
A152724
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6109
LICENSE
MN
Enumeration date
09/28/2018
Last updated
09/18/2020
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