| Provider / Organization | NPI | Date Certified |
|---|---|---|
| KRISTEN FULLER | 1306428669 | 2023-07-05 |
Kristen Fuller is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1306428669. Registration indicates Kristen Fuller is a provider of access to ophthalmic care services with a specialization in Eye & Vision Services Providers, Optometrist (Eye and Vision Services Providers, Optometrist) (Optometrist, ) (Vision/Audiology, ) (Optometrist, Eye and Vision Services Providers)
| Entity Type | Individual |
| Provider Name | Kristen Fuller |
| Practice Office Address | 35 STATE HOSPITAL DR BANGOR, ME US |
| Practice Office Telephone | 2076238411 |
| Mailing Address | 35 STATE HOSPITAL DR BANGOR, ME 044018816 US |
| Address | City / State | Phone / Fax |
|---|---|---|
| 5303 Glenway Ave | Cincinnati, OH 452383706 | 5139218040 / 5139216483 |
| 2929 Highland Ave | Cincinnati, OH 452192463 | 5135593599 |
| Code | Practice | License No State |
|---|---|---|
| 152W00000X PRIMARY | Access to Ophthalmic Care Eye & Vision Services Providers Optometrist Eye and Vision Services Providers Optometrist Optometrist Vision/Audiology Optometrist Eye and Vision Services Providers | 6995
OH |