Provider Demographics
NPI:1942065354
Name:FULLER CARE NOW, LLC
Entity Type:Organization
Organization Name:FULLER CARE NOW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:FULLER
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:214-405-5556
Mailing Address - Street 1:11617 GROSVENOR LN # 1B
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11418-3510
Mailing Address - Country:US
Mailing Address - Phone:214-405-5556
Mailing Address - Fax:
Practice Address - Street 1:11617 GROSVENOR LN # 1B
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11418-3510
Practice Address - Country:US
Practice Address - Phone:214-405-5556
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-15
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care