Individual
MRS. COURTNEY CAROLE FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSN, RN
Contact information
Practice address
8104 COUNTY ROAD 6500, LUBBOCK, TX 79416-9557
(806) 773-6575
Mailing address
8104 COUNTY ROAD 6500, LUBBOCK, TX 79416-9557
(806) 773-6575
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
671297
TX
Other
Enumeration date
07/25/2011
Last updated
07/25/2011
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