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General NPI Number Information
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NPI Number | 1386154680
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Entity Type | Individual
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Provider Name | ASHLEY ELIZABETH FULLER DNP-C
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Gender | Female
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Dates
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Enumeration Date | 10/02/2017
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Last Update Date | 03/28/2019
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Provider Practice Location Address
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Address Line | 222 BOSTON TPKE
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City | SHREWSBURY
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State | MA
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Zip | 01545
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Country | US
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Telephone | 508-853-2854
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Fax | 508-853-4354
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Provider Business Mailing Address
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Address Line | 5 NEPONSET ST FL ST2
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City | WORCESTER
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State | MA
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Zip | 01606-2714
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Country | US
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Telephone | 508-368-5532
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Fax | 508-853-4354
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN283013
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License Number State | MA
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