Individual
MRS. ANTONIA FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
A.R.N.P.
Contact information
Practice address
354 PASEO REYES DRIVE, SAINT AUGUSTINE, FL 32095
(904) 808-8595
(904) 808-8596
Mailing address
354 PASEO REYES DRIVE, SAINT AUGUSTINE, FL 32095
(904) 808-8595
(904) 808-8596
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
1606392
FL
Other
Enumeration date
10/15/2006
Last updated
01/07/2010
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