Individual
JESSICA FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
736 W LINCOLN HWY, EXTON, PA 19341-2547
(484) 999-2100
Mailing address
130 MONUMENT RD APT 507, BALA CYNWYD, PA 19004-1765
(973) 997-6110
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN749550
PA
363LF0000X
Family Nurse Practitioner
Primary
RN749550
PA
Other
Enumeration date
03/31/2026
Last updated
05/12/2026
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