Individual
MRS. DENISE MICHELLE FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
37V369681004
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37V369681004
DEPARTMENT OF HEALTH
OK
Enumeration date
11/17/2011
Last updated
11/17/2011
Update your record
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