Provider Demographics
NPI:1912330945
Name:FULLER, NATHANIEL ASBURY (PA-C)
Entity type:Individual
Prefix:MR
First Name:NATHANIEL
Middle Name:ASBURY
Last Name:FULLER
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6521 BUENA VISTA CT
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-9416
Mailing Address - Country:US
Mailing Address - Phone:706-651-2369
Mailing Address - Fax:
Practice Address - Street 1:3019 N CENTER ST
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-1160
Practice Address - Country:US
Practice Address - Phone:706-910-6708
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-13
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant