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NPI Code Detail

MEDICARE: TALEITHA FULLWOOD

MEDICARE: TALEITHA FULLWOOD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1246RP1900XPhlebotomy TechnicianP9C8R6J6NC

General Provider Information

NPI Number : 1841049194
Entity Type Code : Individual
Provider Name (Legal Business Name) : TALEITHA FULLWOOD
Provider Business Mailing Address
First Line : 701 GREEN VALLEY RD STE 100
Second Line :
City : GREENSBORO
State : NC
Zip : 27408-7096
Country : US
Telephone Number : 800-883-5170
Fax Number :
Provider Business Practice Location Address
First Line : 701 GREEN VALLEY RD STE 100
Second Line :
City : GREENSBORO
State : NC
Zip : 27408-7096
Country : US
Telephone Number : 800-883-5170
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2024
Last Update Date : 05/17/2024

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Directions to “ TALEITHA FULLWOOD ” Practice Location

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