Individual
ANGELA KAY FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
500 E VETERANS ST, TOMAH, WI 54660-3105
(608) 372-3971
(608) 374-8408
Mailing address
S4259 CRAWFORD ST., BARABOO, WI 53913-9118
(608) 963-1090
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
2571-033
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41256600
—
WI
Enumeration date
10/03/2006
Last updated
08/24/2025
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