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Individual
NANCY S. FULLER
Active
Individual
NANCY S. FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
54479-20
WI
208M00000X
Hospitalist Physician
Primary
54479-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
61039
DEAN HEALTH INSURANCE
WI
Enumeration date
03/21/2007
Last updated
01/20/2011
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