Individual
MS. PHILECIA RENEE FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
HOME CARE PROVIDER
Contact information
Practice address
1800 LAKEWOOD DR APT H4, PHENIX CITY, AL 36867-1838
(334) 408-8115
Mailing address
1800 LAKEWOOD DR APT H4, PHENIX CITY, AL 36867-1838
(334) 408-8115
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
376K00000X
Nurse's Aide
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
03/28/2018
Last updated
03/28/2018
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