Greg L. Fullmer, AGNP-C

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

5271681 Issued in ID

Practice address

4815 N Assembly St
Spokane, WA 99205-6185

Phone

(509) 434-7000

NPI assigned

Oct 6, 2025

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1759708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759708800000",
    "number": "1215801865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "803 E ELM AVE",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838144438",
            "telephone_number": "619-456-1337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4815 N ASSEMBLY ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992056185",
            "telephone_number": "509-434-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLMER",
        "first_name": "GREG",
        "middle_name": "L.",
        "credential": "AGNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-10-06",
        "last_updated": "2025-10-06",
        "certification_date": "2025-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "ID",
            "license": "5271681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evan D Fuller, PHARMD
• Jeremy R Fuller, CRNA
• Kaylee Fuller
• Taytum Fay Fuller, MS, CCC SLP
• Cari Leann Fullerton, COTA
• Kurt D Fullmer, PA-C
• Megan Erin Funchess, RN
• Function First OT, PLLC
• Jessica Fundin, LPN
• Jodi W Funk, DDS

• Gerontology Nurse Practitioner in Spokane, WA
• Providers in Spokane, WA by specialty
• Gerontology Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.