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
3493 VETERANS DR N STE C, HUNTINGDON, TN 38344-6230
(731) 986-2933
(731) 986-2938
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
APN0000017089
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
11/05/2020
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