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1356406144
LAURA MARIE FULLERTON
PEORIA, IL
NPI
1356406144
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Former Name
LAURA GREEN
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: IL 209-001938)
Enumeration Date
2006-12-22
Last Update Date
2018-07-25
Business Address
Ms. LAURA MARIE FULLERTON APN
2321 N WISCONSIN AVE
PEORIA, IL 61603
Phone number: 309-680-7600
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Mailing Address
Ms. LAURA MARIE FULLERTON APN
2214 N UNIVERSITY ST
PEORIA, IL 61604-3221
Phone number: 309-680-7600
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