# KELLI M. FULLER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1952544017
- **Gender:** F
- **Credential:** ANP-BC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163W00000X | Registered Nurse | 131425 | MO | — |
| 163W00000X | Registered Nurse | 209-003174 | IL | — |
| 163W00000X | Registered Nurse | 2533252 | FL | — |
| 363LA2200X | Adult Health Nurse Practitioner | 131425 | MO | Yes |

## Other

- **Enumeration date:** 04/18/2009
- **Last updated:** 07/01/2019