Individual provider · Type 1 NPI

Samantha Ellen Fullmer

Family Nurse Practitioner · Mesa, AZ

NPI number 1265031496 Active

Practice location

1705 W Main St
Mesa, AZ 85201-6920

Fax (480) 718-9477

Mailing address

3033 N Central Ave Ste 145
Phoenix, AZ 85012-2808

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000X223113 (AZ)
General Practice Physician 208D00000X223113 (AZ)

Family Nurse Practitioner: Definition to come...

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About NPI 1265031496

Samantha Ellen Fullmer's National Provider Identifier is 1265031496, issued on Oct 19, 2020. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Mesa, AZ. The record was last updated on May 3, 2023.