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General NPI Number Information
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NPI Number | 1174878516
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Entity Type | Individual
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Provider Name | MEGAN H FULLER NP
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Gender | Female
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Dates
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Enumeration Date | 07/23/2012
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Last Update Date | 02/02/2023
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Provider Practice Location Address
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Address Line | 2515 DESALES AVE STE 204
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City | CHATTANOOGA
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State | TN
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Zip | 37404-1100
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Country | US
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Telephone | 423-654-7670
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Fax | 423-654-7671
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Provider Business Mailing Address
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Address Line | 2515 DESALES AVE STE 204
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City | CHATTANOOGA
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State | TN
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Zip | 37404-1100
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Country | US
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Telephone | 423-654-7670
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Fax | 423-654-7671
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APN16867
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN298561
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License Number State | GA
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