| NPI | 1225757842 |
|---|---|
| Former Name | KATHERINE ELIZABETH FULLER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: WI 13094-33) |
| Enumeration Date | 2022-08-25 |
| Last Update Date | 2023-02-07 |