Individual
WENDY BRANNAN FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3720 DAVINCI CT, STE 400, NORCROSS, GA 30092-7627
(478) 288-6308
(770) 582-4189
Mailing address
3720 DAVINCI COURT, STE 400, NORCROSS, GA 30092
(478) 288-6308
(770) 582-4189
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN093416
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
894206368F
—
GA
Enumeration date
08/07/2006
Last updated
08/03/2015
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