Individual
STACIE FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1200 1ST AVE E STE 1, SPENCER, IA 51301-4330
(712) 578-9743
Mailing address
1200 1ST AVE E STE 1, SPENCER, IA 51301-4330
(712) 578-9743
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
160062
IA
Other
Enumeration date
05/27/2026
Last updated
05/27/2026
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