Doctor Name: | TERESA FULLEN |
NPI Number: | 1578880647 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-C |
License Number: | 0024168776 |
Business Practice Address: | 308 W Main St Saltville, VA - 243703112 |
Business Phone Number: | 2764964433 |
Business Fax Number: | 2764965923 |
Mailing Address: | Po Box 729, SALTVILLE |
State: | VA |
Postal Code: | 243700729 |
Phone Number: | 2764964492 |
Fax Number: | 2764964839 |
NPI Enumeration Date: | 04/28/2010 |
NPI Last Update Date: | 09/04/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 364SF0001X |
License Number: | 0024168776 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | VA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Clinical Nurse Specialist |
Taxonomy Specialization: | Family Health |
Taxonomy Definition: |