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1124347786
DIANNE LEE FULLER
SALT LAKE CITY, UT
NPI
1124347786
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Former Name
DIANNE LEE FULLER CLYDE
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: UT 308008-4405)
Enumeration Date
2010-05-21
Last Update Date
2010-05-21
Business Address
-- DIANNE LEE FULLER FNP-C
3690 S MAIN ST
SALT LAKE CITY, UT 84115-4423
Phone number: 801-910-3690
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Mailing Address
-- DIANNE LEE FULLER FNP-C
10 S 2000 E UNIVERSITY OF UTAH COLLEGE OF NURSING
SALT LAKE CITY, UT 84112-5880
Phone number: 801-582-5573
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