Individual
MRS. SUSAN FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RNC WHNP
Contact information
Practice address
601 JOHN ST, SUITE M318, KALAMAZOO, MI 49007-5383
(269) 345-6197
(269) 345-9734
Mailing address
601 JOHN ST, SUITE M318, KALAMAZOO, MI 49007-5383
(269) 345-6197
(269) 345-9734
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
4704116309
MI
Other
Enumeration date
09/15/2005
Last updated
01/04/2008
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