Fuller, Amanda Ruth

Fuller, Amanda Ruth is an individual health care provider with primary practice located at 3493 Veterans Dr N Ste C , Huntingdon TN 38344-6230. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Fuller, Amanda Ruth can be contacted via phone (731) 986-2933.

Contact Information

Primary practice address
3493 Veterans Dr N Ste C Huntingdon TN 38344-6230
Phone: (731) 986-2933
Fax: (731) 986-2938
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X APN0000017089 Tennessee
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X APN0000017089 Tennessee

Profile Details

NPI number 1891048765
LBN Legal business name Fuller, Amanda Ruth
Credentials FNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 17th, 2012
Last updated Nov 5th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891048765 NPPES
Tennessee MEDICAID Q001034
Tennessee MEDICAID Q054963

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