Individual
MELODY RENE FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
744 ARDEN LN STE 200, ROCK HILL, SC 29732-3287
(803) 787-6453
Mailing address
520 INNER BANKS RD, BOILING SPRINGS, SC 29316-6170
(864) 541-9363
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
23579
SC
363LF0000X
Family Nurse Practitioner
Primary
23579
SC
Other
Enumeration date
09/30/2020
Last updated
01/02/2025
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