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Individual
KISTI POPE FULLER
Active
Individual
KISTI POPE FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
24641
NV
207VM0101X
Maternal & Fetal Medicine Physician
Primary
48767
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1912165713
—
CT
01
—
24641
STATE LICENSE
NV
Enumeration date
05/28/2008
Last updated
04/02/2024
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