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

Susan Rutkowski Fuller, NURSEPRACTITIONER

Individual provider Family Nurse Practitioner · NPI 1669090783

Susan Rutkowski Fuller, NURSEPRACTITIONER is a Nurse Practitioner in Wake Forest, North Carolina. Qualified in 2020, 6 years ago. Practices with Select Physical Therapy Holdings Inc, a 2,121-clinician group and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
6
Licensed in
NC
In the registry since
2020
Specialties on file
2
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Practice location Address checks out

3635 Rogers Rd
Wake Forest, NC 27587-7634
Phone: (919) 787-7246
Fax: (919) 787-7247
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 5013256 (NC)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 5013256 (NC)

Record details

NPI number1669090783
Entity typeIndividual (Type 1)
GenderFemale
Credentials NURSEPRACTITIONER
Sole proprietorYes
NPI enumeratedJuly 7, 2020
Last updated in NPPESApril 28, 2025
Certification dateApril 1, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Select Physical Therapy Holdings Inc — 2121 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Wake Forest