Individual
MARY FULLER-FOUGEROUSSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
502 W 29TH ST, TUCSON, AZ 85713-3353
(520) 884-9920
Mailing address
502 W 29TH ST, TUCSON, AZ 85713-3353
(520) 884-9920
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP3545
AZ
Other
Enumeration date
01/05/2010
Last updated
02/22/2013
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