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Individual

LAURA MARIE FULLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS,RDN,LD

Contact information

Practice address
197 N MCCLEARY RD, EXCELSIOR SPRINGS, MO 64024-8490
(816) 922-2411
(816) 922-4644
Mailing address
197 N MCCLEARY RD, EXCELSIOR SPRINGS, MO 64024-8490
(816) 922-2411
(816) 922-4644

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
1859
KS
133V00000X
Registered Dietitian
Primary
2001026126
MO

Other

Enumeration date
07/27/2015
Last updated
07/27/2015
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