| Anna R Fullmer, MSSW, LCSW | |
|
400 S Townline Rd, Wautoma, WI 54982-6922 | |
| (920) 787-5514 | |
| Not Available |
| Full Name | Anna R Fullmer |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 400 S Townline Rd, Wautoma, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306897467 | NPI | - | NPPES |
| 39797500 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 6573-123 (Wisconsin) | Primary |
| Entity Name | La Clinica De Los Campesinos, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1790786929 PECOS PAC ID: 8729996574 Enrollment ID: O20040806000058 |
| Mailing Address | Practice Location Address |
|---|---|
| Anna R Fullmer, MSSW, LCSW 400 S Townline Rd, Wautoma, WI 54982-6922 Ph: (920) 787-5514 | Anna R Fullmer, MSSW, LCSW 400 S Townline Rd, Wautoma, WI 54982-6922 Ph: (920) 787-5514 |
Mrs. Laurinda S Wittenhagen, LCSW Clinical Social Worker Medicare: May Accept Medicare Assignments Practice Location: 380 S Townline Rd, Wautoma, WI 54982 Phone: 920-787-6550 Fax: 920-787-0421 | |
Ms. Jennifer A Ward, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 380 S Townline Rd, Wautoma, WI 54982 Phone: 920-787-6550 Fax: 920-787-0421 | |
Mrs. Clara L Voigtlander, LCSW Clinical Social Worker Medicare: May Accept Medicare Assignments Practice Location: 380 S Townline Rd, Wautoma, WI 54982 Phone: 920-787-6550 Fax: 920-787-0421 | |
Megan Schwobe, APSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 400 S Townline Rd, Wautoma, WI 54982 Phone: 920-787-5514 Fax: 920-787-4737 |