Individual
SOPHIA FULLERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8055 O ST STE 119B, LINCOLN, NE 68510-2565
(402) 207-9200
Mailing address
631 E 4TH ST, SUPERIOR, NE 68978-1917
(402) 879-8460
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
—
—
372600000X
Adult Companion
Primary
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Enumeration date
04/21/2025
Last updated
04/21/2025
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