Individual provider · Type 1 NPI
Jalisa Fuller
Driver · Bossier City, LA
NPI number
1982270088
Active
Practice location
1621 Williamsburg Dr
Bossier City, LA 71112-3165
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Driver Primary | 172A00000X | 009494849 (LA) |
Driver: A person employed to operate a motor vehicle as a carrier of persons or property.
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About NPI 1982270088
Jalisa Fuller's National Provider Identifier is 1982270088, issued on May 28, 2021. The primary taxonomy on file is Driver (172A00000X), and the practice location is in Bossier City, LA. The record was last updated on May 28, 2021.