Individual
LAUREL FULKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2034 W MONTE CRISTO AVE, PHOENIX, AZ 85023
(480) 231-3659
Mailing address
2034 W MONTE CRISTO AVE, PHOENIX, AZ 85023
(480) 231-3659
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP054360
AZ
Other
Enumeration date
05/07/2024
Last updated
05/07/2024
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