Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DIANA FULLER,MICOU
Active Sole ProprietorDIANA FULLER,MICOU is a Voluntary or Charitable healthcare provider located in KOSCIUSKO, Mississippi. NPI 1205348554 is currently active in the NPPES registry. Verify at CMS.
Voluntary or Charitable · KOSCIUSKO, MS
Registration Details
- NPI Number
- 1205348554
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Oct 26, 2017 (8.8186714564556 yrs)
- Last Updated
- Oct 26, 2017
- Sole Proprietor
- Yes
Practice Information
- Address
-
825 JAMES H MEREDITH STKOSCIUSKO, MS, 390903161Browse MS providers · Browse ZIP 39090
- Phone
- 6622893699
- Primary Specialty
-
Voluntary or Charitable
251V00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.