Individual
ANNA FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2001 S JONES BLVD STE K, LAS VEGAS, NV 89146-3165
(702) 202-3452
Mailing address
2001 S JONES BLVD STE K, LAS VEGAS, NV 89146-3165
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
376J00000X
Homemaker
—
—
Other
Enumeration date
10/18/2018
Last updated
10/18/2018
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