DESTINY FULLER

MACON, GA
NPI1972108256
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy164W00000X Licensed Practical Nurse
(Licence: GA  LPN098619)
Enumeration Date2020-12-03
Last Update Date2020-12-03
Business Address
DESTINY FULLER LPN
1389 JACKSON ST
MACON, GA 31201-2207
Phone number: 478-305-9558
Mailing Address
DESTINY FULLER LPN
1389 JACKSON ST
MACON, GA 31201-2207
Phone number:
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