Individual
ANGELA B FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, PA-C
Contact information
Practice address
2710 SAINT FRANCIS DR, SUITE 210, WATERLOO, IA 50702-5619
(319) 272-5000
(319) 272-2167
Mailing address
2101 KIMBALL AVE, LL14, WATERLOO, IA 50702-5063
(319) 272-1590
(319) 272-1535
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
000643
IA
Other
Enumeration date
06/28/2006
Last updated
07/13/2007
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