Nathanael Keith Fuller, PA Valid NPI

Individual provider · Medical Physician Assistant · Manning, IA

NPI

1144583451

Type

Individual (Type 1)

Primary specialty

Medical Physician Assistant (Physician Assistant)

Specialty group

Physician Assistants & Advanced Practice Nursing Providers

Taxonomy code

363AM0700X

License number

002297 (IA)

Sex

Male

Sole proprietor

No

Enumerated

2012-06-21

Last updated

2014-06-13