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Contact Information

KISTI P FULLER, MD
1840 S STAPLEY DR STE 131
MESA, AZ85204-6683
 Phone: 480-866-8787
 Fax: 480-863-9770
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Maternal & Fetal Medicine

207VM0101X 16 Physician/Obstetrics & Gynecology
Indicates primary specialty

NPI Profile & details for KISTI P FULLER · (Female)

NPI # 1912165713
Status Active
Credentials MD
Entity Individual
Enumeration date 05/28/2008
Last updated 04/02/2024 - About 2 years ago
Sole proprietor 1 No
Identifiers
  • AZ License # 48767
  • NV License # 24641
  • CT Medicaid 1912165713
  • NV Other 24641 STATE LICENSE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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