Individual
MRS. REBECCA FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN, RN
Contact information
Practice address
13335 W MISSOURI AVE, LITCHFIELD PARK, AZ 85340-8500
(623) 547-1218
Mailing address
13335 W MISSOURI AVE, LITCHFIELD PARK, AZ 85340-8500
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
2002018759
MO
Other
Enumeration date
04/16/2013
Last updated
04/16/2013
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