Individual provider · Type 1 NPI
Diana Fuller,micou
Voluntary or Charitable Agency · Kosciusko, MS
NPI number
1205348554
Active
Practice location
825 James H Meredith St
Kosciusko, MS 39090-3161
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Voluntary or Charitable Agency Primary | 251V00000X | None listed |
Voluntary or Charitable Agency: Definition to come...
About NPI 1205348554
Diana Fuller,micou's National Provider Identifier is 1205348554, issued on Oct 26, 2017. The primary taxonomy on file is Voluntary or Charitable Agency (251V00000X), and the practice location is in Kosciusko, MS. The record was last updated on Sep 29, 2026.