Individual
POLLY FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-0001
(801) 581-2121
Mailing address
926 FREMONT RD, BOUNTIFUL, UT 84010-1466
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
10961103-3102
UT
Other
Enumeration date
09/08/2025
Last updated
10/24/2025
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