MICHAEL FULLER

MAYFIELD, KY
NPI1013577667
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy164W00000X Licensed Practical Nurse
(Licence: TN  LPN0000092565)
Enumeration Date2019-06-17
Last Update Date2019-06-17
Business Address
MICHAEL FULLER LPN
1539 CUBA RD
MAYFIELD, KY 42066-6809
Phone number: 270-251-2924
Mailing Address
MICHAEL FULLER LPN
425 BROADWAY ST STE 201
PADUCAH, KY 42001-0713
Phone number: 270-442-7121