Individual
NICOLE FRANKLIN FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5958 MILL BRANCH CLUB RD, BROOKLET, GA 30415-5307
(404) 630-6414
Mailing address
5958 MILL BRANCH CLUB RD, BROOKLET, GA 30415-5307
(404) 630-6414
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
GA
Other
Enumeration date
03/16/2021
Last updated
03/16/2021
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