Organization
FULLER LIFE HEALTH AND WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTINA WATT FULLER LPCC-S (OWNER)
(270) 791-8189
Entity
Organization
Contact information
Practice address
130 HUNTER CT STE 3, BOWLING GREEN, KY 42103-7032
(270) 904-5104
Mailing address
431 CLAYPOOL BOYCE RD, ALVATON, KY 42122-8732
(270) 904-5104
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/06/2025
Last updated
09/06/2025
Update your record
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