Individual
KELLY DAWN FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4498 POTOMAC HIGHLANDS TRL, GREEN BANK, WV 24944-8514
(304) 456-5115
(855) 435-1142
Mailing address
5384 STAUNTON PARKERSBURG TPKE, BARTOW, WV 24920-8043
(304) 517-8108
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
WV
Other
Enumeration date
04/20/2026
Last updated
04/20/2026
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