Individual
MINDY ANN FULTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
302 ENTERPRISE DR, INDEPENDENCE, IA 50644-9601
(319) 334-7131
(319) 334-7133
Mailing address
3068 OVERLAND AVE, ROWLEY, IA 52329-9793
(319) 721-8198
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
18408
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18408
IOWA BOARD OF PHARMACY
IA
Enumeration date
04/01/2019
Last updated
04/01/2019
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