Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Greg L. Fullmer, AGNP-C

Individual provider Gerontology Nurse Practitioner · NPI 1215801865

Greg L. Fullmer, AGNP-C is a Gerontology Nurse Practitioner in Spokane, Washington. Practices as a sole proprietor. Licensed in Idaho.

Licensed in
ID
In the registry since
2025

Practice location Address checks out

4815 N Assembly St
Spokane, WA 99205-6185
Phone: (509) 434-7000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Gerontology Nurse Practitioner (primary) Taxonomy 363LG0600X · Licence 5271681 (ID)

Record details

NPI number1215801865
Entity typeIndividual (Type 1)
GenderMale
Credentials AGNP-C
Sole proprietorYes
NPI enumeratedOctober 6, 2025
Last updated in NPPESOctober 6, 2025
Certification dateSeptember 10, 2025
Mailing address803 E Elm Ave, Coeur D Alene, ID 83814-4438

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