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Individual

ANYE' LASHAE FULSOM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN-BSN

Contact information

Practice address
1033 CORPORATE SQUARE DR STE 123, SAINT LOUIS, MO 63132-2928
(314) 805-9495
Mailing address
1033 CORPORATE SQUARE DR STE 123, SAINT LOUIS, MO 63132-2928

Taxonomy

Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
2016031096
MO

Other

Enumeration date
04/24/2023
Last updated
05/02/2023
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