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Individual

TAMMY FULLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
QSP, MED TECH, CPR

Contact information

Practice address
43 HORSESHOE BND, HORACE, ND 58047-5718
(701) 405-5557
Mailing address
43 HORSESHOE BND, HORACE, ND 58047-5718
(701) 405-5557

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
ND

Other

Enumeration date
05/16/2021
Last updated
05/16/2021
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