Individual
MS. KELLI LYNNE FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.S.
Contact information
Practice address
4600 S SPRINGHILL JCT, TERRE HAUTE, IN 47802-4584
(812) 242-2244
(812) 242-2210
Mailing address
629 S 23RD ST, TERRE HAUTE, IN 47803-2541
(812) 242-2534
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/04/2006
Last updated
07/09/2007
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