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Individual

MRS. NANCY MARIE FULLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
913 NW GARDEN VALLEY BLVD, VA ROSEBURG HEALTHCARE SYSTEM, ROSEBURG, OR 97471-6523
(541) 440-1000
(541) 440-1230
Mailing address
913 NW GARDEN VALLEY BLVD, VA ROSEBURG HEALTHCARE SYSTEM, ROSEBURG, OR 97471-6523
(541) 440-1000
(541) 440-1230

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
201050069NP
OR
363LA2200X
Adult Health Nurse Practitioner
Primary
209-003019
IL

Other

Enumeration date
07/05/2006
Last updated
06/19/2013
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