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NPI Profile for EDWANA D FULLER in CHICAGO, IL.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Medical-Surgical |
163WM0705X |
| NPI # | 1760090765 |
|
| Status | Active | |
| Credentials | RN (Registered Nurse) | |
| Entity | Individual | |
| Enumeration date | 07/16/2020 | |
| Last updated | 07/16/2020 - About 6 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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EDWANA D FULLER
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EDWANA D FULLER, RN