NPI | 1154733830 |
---|---|
Former Name | DEMETRIA S FULLER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: VA 0001211714) |
Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: VA HCO-251653) |
164W00000X Licensed Practical Nurse (Licence: VA HCO-251653) | |
251E00000X Home Health (Licence: VA HCO-251653) | |
251J00000X Nursing Care (Licence: VA HCO-251653) | |
3747P1801X Technician, Personal Care Attendant (Licence: VA HCO-251653) | |
385H00000X Respite Care (Licence: VA HCO-251653) | |
Enumeration Date | 2014-05-29 |
Last Update Date | 2023-08-06 |