Individual
LISA MILLER FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 N ACADEMY AVE, DANVILLE, PA 17822-9800
(570) 271-6763
Mailing address
33 LEE AVE, MOUNTAIN TOP, PA 18707-1109
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN686160
PA
Other
Enumeration date
10/16/2023
Last updated
10/16/2023
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