Individual
FELICIA LAJEAN FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
3113 S 70TH ST, FORT SMITH, AR 72903
(479) 452-6650
(479) 452-5847
Mailing address
PO BOX 11818, FORT SMITH, AR 72917-1818
(479) 452-6650
(478) 452-5847
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
214133
AR
Other
Enumeration date
07/12/2018
Last updated
05/14/2021
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