Individual
BOBBI FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
709 S. WASHINGTON AVE, SUITE B, EMMETT, ID 83617
(208) 740-8808
Mailing address
709 S. WASHINGTON AVE, SUITE B, EMMETT, ID 83617
(208) 740-8808
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
55108
ID
Other
Enumeration date
07/27/2020
Last updated
11/01/2022
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