Individual
NIKOL FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
290 N WAYTE LN # 1300, FRESNO, CA 93701-2124
(866) 342-6012
Mailing address
2625 E DIVISADERO ST, FRESNO, CA 93721-1431
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
95006169
CA
363LP0200X
Pediatric Nurse Practitioner
Primary
95006169
CA
Other
Enumeration date
01/24/2017
Last updated
01/14/2020
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