Fuller, Jeffrey S

Fuller, Jeffrey S is an individual health care provider with primary practice located at 1406 W Bella Drive , Marion IN 46953-5229. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as his primary health care specialty. Fuller, Jeffrey S can be contacted via phone (765) 662-7720.

Contact Information

Primary practice address
1406 W Bella Drive Marion IN 46953-5229
Phone: (765) 662-7720
Fax: (765) 573-5660
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 71002856A Indiana

Profile Details

NPI number 1871731935
LBN Legal business name Fuller, Jeffrey S
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 28th, 2009
Last updated Oct 20th, 2020 - about 6 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1871731935 NPPES
Indiana Other 000000600494 ANTHEM
Indiana MEDICAID 200929110 ANTHEM

Popular Providers