Individual
DIANNE LEE FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
3690 S MAIN ST, SALT LAKE CITY, UT 84115-4423
(801) 910-3690
Mailing address
10 S 2000 E, UNIVERSITY OF UTAH COLLEGE OF NURSING, SALT LAKE CITY, UT 84112-5880
(801) 582-5573
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
308008-4405
UT
Other
Enumeration date
05/21/2010
Last updated
05/21/2010
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