Individual
NICOLE FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2500 N 67TH ST, LINCOLN, NE 68507-2807
(402) 436-1216
(402) 458-3216
Mailing address
2500 N 67TH ST, LINCOLN, NE 68507-2807
(402) 436-1216
(402) 458-3216
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
59255
NE
Other
Enumeration date
03/06/2018
Last updated
03/06/2018
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