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Individual

CARA NICOLE FULLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
212 E DUKE STREET, HUGO, OK 74743
(580) 326-2200
Mailing address
712 SE 1ST ST, ANTLERS, OK 74523-4216
(602) 386-0012

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
04/03/2024
Last updated
04/03/2024
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