Individual
KIMBERLY TILLMAN FULMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
34 NW BROAD ST, METTER, GA 30439-4025
(912) 685-4040
Mailing address
739 BURTON AVE, METTER, GA 30439-3303
(912) 690-2652
(833) 637-2036
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN139827
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1780348060
NPI
GA
Enumeration date
10/24/2021
Last updated
01/21/2026
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