Individual
ANNE B FULLMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
709 N LINCOLN AVE, JEROME, ID 83338-1851
(208) 814-9772
Mailing address
709 N LINCOLN AVE, JEROME, ID 83338-1851
(208) 814-9772
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
N-38467
ID
Other
Enumeration date
10/06/2015
Last updated
10/06/2015
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