IndividualActive
Greg Fullmer, AGNP-C
NPI 1215801865 · Gerontology Nurse Practitioner · Spokane, WA
Provider details
- NPI number
- 1215801865
- Entity type
- Individual
- Primary specialty
- Gerontology Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- AGNP-C
- Sex
- Male
- Sole proprietor
- Yes
- License
- 5271681 (ID)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
4815 N Assembly St
Spokane, WA 99205-6185
Phone: (509) 434-7000
Approximate (ZIP-level) locationGet directions
Mailing address
803 E Elm Ave
Coeur D Alene, ID 83814-4438
Registry dates
- Enumerated
- 2025-10-06
- Last updated
- 2025-10-06
- Certified
- 2025-09-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.