Individual
LAUREN FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14725 W MOUNTAIN VIEW BLVD, SURPRISE, AZ 85374-2704
(623) 243-9077
Mailing address
3010 W 7TH ST APT 302, LITTLE ROCK, AR 72205-6031
(501) 766-1355
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/02/2025
Last updated
07/02/2025
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