Individual
TAMMI PAULINE FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM, MS
Contact information
Practice address
1302 PENNSYLVANIA AVE, HAGERSTOWN, MD 21742-3108
(240) 313-3463
Mailing address
1302 PENNSYLVANIA AVE, HAGERSTOWN, MD 21742-3108
(240) 313-3463
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
R122479
MD
Other
Enumeration date
09/29/2005
Last updated
03/21/2012
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