Individual
AMBER MARIE FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
240 LISBON AVE # 1, BUFFALO, NY 14215-1028
(716) 204-6769
Mailing address
240 LISBON AVE # 1, BUFFALO, NY 14215-1028
(716) 204-6769
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
338360
NY
Other
Enumeration date
12/18/2021
Last updated
12/18/2021
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