Individual
MRS. EVE RENEE FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, LVN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
95133035
CA
164X00000X
Licensed Vocational Nurse
VN 195375
CA
Other
Enumeration date
07/29/2010
Last updated
06/06/2018
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