Provider Demographics
NPI:1437973039
Name:FULLMER, ASHLEY (RN, BSN)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:FULLMER
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2540 KRAMERIA ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80207-3437
Mailing Address - Country:US
Mailing Address - Phone:720-480-9746
Mailing Address - Fax:
Practice Address - Street 1:2540 KRAMERIA ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80207-3437
Practice Address - Country:US
Practice Address - Phone:720-480-9746
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-11
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.1685441163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse