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1154085629
CHARISSE N FULLWOOD
RALEIGH, NC
NPI
1154085629
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: NC 0000000)
Enumeration Date
2021-10-29
Last Update Date
2021-12-06
Business Address
Miss CHARISSE N FULLWOOD PMHNP-BC
10901 WORLD TRADE BLVD
RALEIGH, NC 27617-4203
Phone number: 919-372-4408
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Mailing Address
Miss CHARISSE N FULLWOOD PMHNP-BC
10901 WORLD TRADE BLVD
RALEIGH, NC 27617-4203
Phone number: 919-372-4408
Copy
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