Individual
BRANDI FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
474 N YELLOW SPRINGS ST, SPRINGFIELD, OH 45504-2463
(937) 399-9500
(937) 342-4242
Mailing address
474 N YELLOW SPRINGS ST, SPRINGFIELD, OH 45504-2463
(937) 399-9500
(937) 342-4242
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN.149539-M-IV
OH
Other
Enumeration date
03/28/2016
Last updated
12/20/2016
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