Provider Demographics
NPI:1396104451
Name:FULLER, ALEXA MARIE (WHNP-BC, APN, MS)
Entity type:Individual
Prefix:MRS
First Name:ALEXA
Middle Name:MARIE
Last Name:FULLER
Suffix:
Gender:F
Credentials:WHNP-BC, APN, MS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1805 SHEA CENTER DR STE 450
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-2255
Mailing Address - Country:US
Mailing Address - Phone:303-738-1100
Mailing Address - Fax:303-738-1310
Practice Address - Street 1:2352 MEADOWS BLVD STE 255
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80109-8417
Practice Address - Country:US
Practice Address - Phone:303-738-1100
Practice Address - Fax:303-738-1310
Is Sole Proprietor?:No
Enumeration Date:2016-02-17
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO0991928363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health