Doctor Name: | MRS. TRICIA E FULLER |
NPI Number: | 1093909418 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | N.P. |
License Number: | 202365 |
Business Practice Address: | 133 Littleton Rd Suite 202 Westford, MA - 018863198 |
Business Phone Number: | 9785896700 |
Business Fax Number: | 9785896707 |
Mailing Address: | 133 Littleton Rd, Suite 202 WESTFORD |
State: | MA |
Postal Code: | 018863198 |
Phone Number: | 9785896700 |
Fax Number: | 9785896707 |
NPI Enumeration Date: | 08/29/2007 |
NPI Last Update Date: | 08/29/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | 202365 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |