Healthcare Provider Details

I. General information

NPI: 1346801883
Provider Name (Legal Business Name): CHRISTY HILL FULLER CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTY J HILL CHRISTYJ HILL-FULLER

II. Dates (important events)

Enumeration Date: 06/25/2019
Last Update Date: 06/13/2024
Certification Date: 06/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47344 US HIGHWAY 78
LINCOLN AL
35096-6748
US

IV. Provider business mailing address

PO BOX 11407
BIRMINGHAM AL
35202-1407
US

V. Phone/Fax

Practice location:
  • Phone: 205-763-7848
  • Fax: 205-763-7235
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number1-149018
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-149018
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: