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1790023679
KACIE LEIGH FULLER
TUSCUMBIA, AL
NPI
1790023679
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: AL 1-113225)
Enumeration Date
2013-01-28
Last Update Date
2013-01-28
Business Address
-- KACIE LEIGH FULLER CRNP
234 KELLER PARK BLVD
TUSCUMBIA, AL 35674-1417
Phone number: 256-381-6963
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Mailing Address
-- KACIE LEIGH FULLER CRNP
234 KELLER PARK BLVD
TUSCUMBIA, AL 35674-1417
Phone number: 256-381-6963
Copy
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