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Contact Information

JAYME FULLER, PA-C
4100 LAKE OTIS PKWY STE 108
ANCHORAGE, AK99508-5230
 Phone: 907-563-3145
 Fax: 833-464-5196
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgical

363AS0400X 97 Physician Assistant
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for JAYME FULLER · (Female)

NPI # 1306490446
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 07/26/2019
Last updated 11/27/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • AK License # 170490
Hospital affiliation(s)
  • ALASKA REGIONAL HOSPITAL - (Acute Care)
    2801 DEBARR ROAD
    ANCHORAGE, AK 99508
  • PROVIDENCE ALASKA MEDICAL CENTER - (Acute Care)
    BOX 196604
    ANCHORAGE, AK 99508
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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