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CYNTHIA ELAINE FULLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1025 MONTGOMERY HWY, SUITE 211, VESTAVIA, AL 35216-2805
(205) 822-9544
(205) 822-9544
Mailing address
PO BOX 661495, BIRMINGHAM, AL 35266-1495
(205) 979-5882
(205) 979-1248

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1-073898
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1467474627
UNITED BEHAVIORAL HEALTH
AL
01
51530421
BLUE CROSS #
AL
Enumeration date
07/24/2006
Last updated
06/23/2011
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