Individual
MRS. KATHRYN AIMEE FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, CFNP
Contact information
Practice address
1370 ROSECRANS ST, STE A, SAN DIEGO, CA 92106-2638
(619) 223-2668
(619) 223-2698
Mailing address
1370 ROSECRANS ST, STE A, SAN DIEGO, CA 92106-2638
(619) 223-2668
(619) 223-2698
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
11440
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11440
CAL. LICENSE NUMBER
CA
Enumeration date
09/26/2006
Last updated
09/17/2008
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