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1659879096
TINA FULLER
CAPE GIRARDEAU, MO
NPI
1659879096
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: MO 2006025670)
Enumeration Date
2018-01-31
Last Update Date
2018-01-31
Business Address
TINA FULLER LPN
340 S BROADVIEW ST
CAPE GIRARDEAU, MO 63703-5703
Phone number: 573-332-0416
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Mailing Address
TINA FULLER LPN
340 S BROADVIEW ST
CAPE GIRARDEAU, MO 63703-5703
Phone number: 573-332-0416
Copy
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