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Omar Kevin Fuller
Psychiatric/Mental Health Nurse Practitioner in Loganville, Georgia
NPI 1932833050

Omar Kevin Fuller is a Psychiatric/Mental Health Nurse Practitioner based in Loganville, GA and is specialized in Psychiatric/Mental Health. Omar Kevin Fuller practices in Loganville, GA. The NPI Number for Omar Kevin Fuller is 1932833050 and holds a License No. RN264780 (Georgia).

The current practice location address for Omar Kevin Fuller is 487 Thomas Dr, Loganville, GA and can be reached out via phone at 973-572-8260.

Location: 487 Thomas Dr, Loganville, GA, 30052-7262
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1932833050
Provider Name
Omar Kevin Fuller
Credential
Provider Entity Type
Individual
Gender
Male
Address
487 Thomas Dr, Loganville, GA, 30052-7262
Phone Number
973-572-8260
Fax Number
Provider Enumeration Date
07/14/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
487 Thomas Dr
City
Loganville
State
Georgia
Zip
30052-7262
Phone Number
973-572-8260
Fax Number
person
Provider Business Mailing Address Details
Address
487 Thomas Dr
City
Loganville
State
Georgia
Zip
30052-7262
Phone Number
973-572-8260
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Psychiatric/Mental Health
Taxonomy
363LP0808X
License No.
RN264780 (Georgia)
Definition
Definition to come...
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