Individual
AMANDA RUTH FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
3493 VETERANS DR N STE C, HUNTINGDON, TN 38344-6230
(731) 986-2933
(731) 986-2938
Mailing address
350 N HUMPHREYS BLVD, MEMPHIS, TN 38120-2177
(901) 226-4003
(901) 227-8591
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
APN0000017089
TN
363LF0000X
Family Nurse Practitioner
Primary
17089
TN
363LF0000X
Family Nurse Practitioner
Primary
APN0000017089
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q001034
—
TN
05
—
Q054963
—
TN
Enumeration date
10/17/2012
Last updated
06/30/2026
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