Fullmer, Samantha Ellen

Fullmer, Samantha Ellen is an individual health care provider with primary practice located at 1705 W Main St , Mesa AZ 85201-6920. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Allopathic & Osteopathic Physicians / General Practice. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Fullmer, Samantha Ellen can be contacted via phone (480) 964-2273.

Contact Information

Primary practice address
1705 W Main St Mesa AZ 85201-6920
Phone: (480) 964-2273
Fax: (480) 718-9477
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 223113 Arizona
Allopathic & Osteopathic Physicians / General Practice 208D00000X 223113 Arizona

Profile Details

NPI number 1265031496
LBN Legal business name Fullmer, Samantha Ellen
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 19th, 2020
Last updated May 3rd, 2023 - about 3 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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