National Provider Identifier Database

KYLE FULLER APRN LLC
Psychiatric/Mental Health


Contact Information

KYLE FULLER APRN LLC
19 S WALNUT ST. STE C
WAUREGAN, CT06387
Phone: 860-207-8160
Fax: 860-207-8170
Website:
Specialty Taxonomy Code
* Psychiatric/Mental Health 364SP0808X
Family Health 364SF0001X

* Indicates primary specialty

NPI Profile & details for KYLE FULLER APRN LLC

NPI Number 1821138470
Legal business name
LBN
KYLE FULLER APRN LLC
Authorized official KYLE FULLER - (OWNER/SOLE PROPRIETOR)
Entity Organization
Organization subpart No
Enumeration date 02/06/2007
Last updated 10/22/2019 - About 7 years ago
Sole proprietor1 Not specified
Identifiers
  • CT License #: 002043

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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