Individual
SUSAN RUTKOWSKI FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
3635 ROGERS RD, WAKE FOREST, NC 27587-7634
(919) 787-7246
(919) 787-7247
Mailing address
3801 WAKE FOREST RD STE 210, RALEIGH, NC 27609-6864
(919) 787-7246
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5013256
NC
363LF0000X
Family Nurse Practitioner
5013256
NC
Other
Enumeration date
07/07/2020
Last updated
04/28/2025
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