Provider Demographics
NPI:1154119493
Name:FULLER, BRITTNEY PAIGE (STNA)
Entity type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:PAIGE
Last Name:FULLER
Suffix:
Gender:
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12335 HONEYLOCUST LN # 34
Mailing Address - Street 2:
Mailing Address - City:GARRETTSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44231-9677
Mailing Address - Country:US
Mailing Address - Phone:234-267-9737
Mailing Address - Fax:
Practice Address - Street 1:12335 HONEYLOCUST LN # 34
Practice Address - Street 2:
Practice Address - City:GARRETTSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44231-9677
Practice Address - Country:US
Practice Address - Phone:234-267-9737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH400648990707376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide