Individual
SUSAN LYNN FULLER-KENEIPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN,BA
Contact information
Practice address
130 W 7TH ST, MOUNT CARMEL, IL 62863-1439
(618) 263-3873
(618) 263-3893
Mailing address
130 W 7TH ST, MOUNT CARMEL, IL 62863-1439
(618) 263-6873
(618) 263-3893
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
—
IL
Other
Enumeration date
04/24/2007
Last updated
07/08/2007
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