# FULLER LIFE HEALTH AND WELLNESS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396625570
- **Authorized official:** KRISTINA WATT FULLER LPCC-S (OWNER)
- **Authorized official phone:** (270) 791-8189

## Contact information

- **Practice address:** 130 HUNTER CT STE 3, BOWLING GREEN, KY 42103-7032
- **Practice address phone:** (270) 904-5104
- **Mailing address:** 431 CLAYPOOL BOYCE RD, ALVATON, KY 42122-8732
- **Mailing address phone:** (270) 904-5104

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | Yes |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 09/06/2025
- **Last updated:** 09/06/2025