Greg L. Fullmer, AGNP-C
Nurse Practitioner, Gerontology in Spokane, WA. Individual provider (NPI-1).
NPI number1215801865
StatusActive
Last updated in NPPESOct 6, 2025
Details
- NPI
- 1215801865
- Entity type
- Individual (NPI-1)
- Name
- Greg L. Fullmer
- Credential
- AGNP-C
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Oct 6, 2025
- Certification date
- Sep 10, 2025
- Last updated
- Oct 6, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LG0600X | Nurse Practitioner, Gerontology | 5271681 | ID | Yes |
Practice location
4815 N Assembly StSpokane, WA 99205-6185
Phone 509-434-7000
Mailing address
803 E Elm AveCoeur D Alene, ID 83814-4438
Phone 619-456-1337
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All 20 Gerontology Nurse Practitioner providers in Spokane · All 16,657 providers in Spokane
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