Individual
HALEY MARIE FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1301 PLEASANT VALLEY RD STE 404, OWENSBORO, KY 42303
(270) 417-7515
(270) 417-7699
Mailing address
PO BOX 23229, OWENSBORO, KY 42304-3229
(270) 688-1330
(270) 688-1338
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1126430
KY
363LG0600X
Gerontology Nurse Practitioner
Primary
3012435
KY
Other
Enumeration date
06/07/2018
Last updated
07/06/2018
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