Fuller, Carla Judith

Fuller, Carla Judith is an sole proprietor health care provider with primary practice located at 88 E Main St , Hornell NY 14843-2074. She recently has only one registered license in Nursing & Custodial Care Facilities / Nursing Care, Pediatric, which is considered as her primary health care specialty. Fuller, Carla Judith can be contacted via phone (585) 201-6166.

Contact Information

Primary practice address
88 E Main St Hornell NY 14843-2074
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Nursing Care, Pediatric 3140N1450X 217696-1 New York

Profile Details

NPI number 1376724211
LBN Legal business name Fuller, Carla Judith
Credentials Licensed Practical Nurse (LPN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 20th, 2007
Last updated Nov 20th, 2007 - about 17 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 1376724211 NPPES
New York MEDICAID 02713931

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