Fuller, Erinn C
Fuller, Erinn C is an individual health care provider with primary practice located at 621 Memorial Dr Ste 302 , South Bend IN 46601-1073. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Fuller, Erinn C can be contacted via phone (574) 367-3800.Contact Information
Primary practice address
621 Memorial Dr Ste 302
South Bend IN 46601-1073
Phone: (574) 367-3800
Fax: (574) 367-3801
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 10001520A | Indiana |
Profile Details
| NPI number | 1295058717 |
|---|---|
| LBN Legal business name | Fuller, Erinn C |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 11th, 2010 |
| Last updated | Jun 25th, 2024 - about last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1295058717 | NPPES |
| Indiana | MEDICAID | 300005961 |
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