Individual provider · Type 1 NPI
Marcia Doreen Fullwood, ANP/GNP
Adult Health Nurse Practitioner · East Orange, NJ
NPI number
1164601225
Active
Practice location
87 Watson Ave
East Orange, NJ 07018-3303
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Health Nurse Practitioner Primary | 363LA2200X | F304754-1 (NY) |
| Gerontology Nurse Practitioner | 363LG0600X | F340688-1 (NY) |
Adult Health Nurse Practitioner: Definition to come...
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About NPI 1164601225
Marcia Doreen Fullwood, ANP/GNP's National Provider Identifier is 1164601225, issued on Oct 25, 2007. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in East Orange, NJ. The record was last updated on Oct 25, 2007.