Individual
CANDACE FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1311 HILLSIDE DR, GAINESVILLE, TX 76240-2923
(940) 284-5815
Mailing address
1311 HILLSIDE DR, GAINESVILLE, TX 76240-2923
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
200104
TX
Other
Enumeration date
04/10/2018
Last updated
04/10/2018
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