Individual
KELSEY ELIZABETH FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
201 STATE ST, ERIE, PA 16550-0002
(814) 877-6000
Mailing address
3435 ANNE MARIE DR, ERIE, PA 16506-6013
(814) 490-4183
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN650355
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
136143
PA
Other
Enumeration date
01/29/2021
Last updated
05/26/2021
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