Individual provider · Type 1 NPI

Jeremy Wayne Fuller, NP-C

Family Nurse Practitioner · Santa Rosa, CA

NPI number 1285221440 Active

Practice location

220 Concourse Blvd
Santa Rosa, CA 95403-8210

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner 363L00000X95015009 (CA)
Family Nurse Practitioner Primary 363LF0000X95015009 (CA)

Family Nurse Practitioner: Definition to come...

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About NPI 1285221440

Jeremy Wayne Fuller, NP-C's National Provider Identifier is 1285221440, issued on Dec 22, 2020. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Santa Rosa, CA. The record was last updated on Feb 24, 2025.