Polly Fuller, RN
Registered Nurse in Salt Lake City, UT. Individual provider (NPI-1).
NPI number1861372005
StatusActive
Last updated in NPPESOct 24, 2025
Details
- NPI
- 1861372005
- Entity type
- Individual (NPI-1)
- Name
- Polly Fuller
- Credential
- RN
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 8, 2025
- Certification date
- Sep 7, 2025
- Last updated
- Oct 24, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163W00000X | Registered Nurse | 10961103-3102 | UT | Yes |
Practice location
50 N Medical DrSalt Lake City, UT 84132-0001
Phone 801-581-2121
Mailing address
926 Fremont RdBountiful, UT 84010-1466
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