Individual
CORTNEY D FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN, RN, ICP, CPN
Contact information
Practice address
200 S 14TH ST STE 140, MIDLOTHIAN, TX 76065-3361
(817) 369-5475
Mailing address
407 WATERLANE DR, MANSFIELD, TX 76063-9105
(574) 261-0391
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
854917
TX
Other
Enumeration date
04/27/2022
Last updated
04/27/2022
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