Individual
MRS. MARY-FAITH FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
12176 S 1000 E, STE G, DRAPER, UT 84020-9734
(801) 523-3030
(801) 523-3033
Mailing address
12176 S 1000 E, STE G, DRAPER, UT 84020-9734
(801) 523-3030
(801) 523-3033
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
7737232-4405
UT
Other
Enumeration date
12/31/2013
Last updated
12/31/2013
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