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1134668213
LAUREN GWEN FULLER
MOAB, UT
NPI
1134668213
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: UT 9826037-3101)
Enumeration Date
2017-02-22
Last Update Date
2017-02-22
Business Address
-- LAUREN GWEN FULLER LPN
198 EAST CENTER STREET
MOAB, UT 84532
Phone number: 435-259-6131
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Mailing Address
-- LAUREN GWEN FULLER LPN
PO BOX 867
PRICE, UT 84501-0867
Phone number: 435-637-7200
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