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KIMBERLY TILLMAN FULMER

>> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1780348060

Individual Registrant:
 KIMBERLY TILLMAN FULMER 
Gender: F
Not Sole Proprietor

Location and contact information for practice:
856 US HIGHWAY 1 S  SWAINSBORO, GA 30401-4984 US
Tel: 478-237-7022  Fax: --

Contact information for business:
739 BURTON AVE  METTER, GA 30439-3303 US
Tel: 912-690-2652  Fax: --

Registration Information:
NPI: 1780348060
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363L00000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
GARN139827

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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