Fuller, Carly Faith

Fuller, Carly Faith is an sole proprietor health care provider with primary practice located at 2300 Opitz Blvd , Woodbridge VA 22191-3311. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is her primary health care specialty. Fuller, Carly Faith can be contacted via phone (703) 915-5550.

Contact Information

Primary practice address
2300 Opitz Blvd Woodbridge VA 22191-3311
Phone: (703) 915-5550
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 0110007223 Virginia
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 0110007223 Virginia

Profile Details

NPI number 1295293611
LBN Legal business name Fuller, Carly Faith
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 5th, 2019
Last updated Dec 29th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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