Individual
HALEY RENEE FULKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
912 WALLACE AVE STE 102, LEITCHFIELD, KY 42754-2405
(270) 259-8888
Mailing address
PO BOX 776879, CHICAGO, IL 60677-6879
(502) 559-9407
(502) 272-5339
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
123904
KY
Other
Enumeration date
08/21/2007
Last updated
12/11/2024
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