Individual
MS. KANIKA SHAVON FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN, RN, PED-BC
Contact information
Practice address
123 HOW LN, NEW BRUNSWICK, NJ 08901-3653
(732) 448-1000
Mailing address
123 HOW LN, NEW BRUNSWICK, NJ 08901-3653
(732) 448-1000
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
26NO11743500
NJ
Other
Enumeration date
05/16/2025
Last updated
05/16/2025
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