Individual
ADONNA FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14O IMPERIAL DRIVE, APT 120, GAHANNA, OH 43230
(614) 787-3299
Mailing address
5613 DERBY FIELD LN UNIT 201, COLUMBUS, OH 43228-2069
(614) 787-3299
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015675
—
OH
Enumeration date
11/02/2020
Last updated
11/02/2020
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