Tianna Jean Fuller, FNP, MSN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

9666776-8900 Issued in UT

Practice address

9898 S Glasgow Dr
South Jordan, UT 84009-9113

Phone

(208) 409-5273

NPI assigned

Jun 9, 2025

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1749427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1013802305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9898 S GLASGOW DR",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840099113",
            "telephone_number": "208-409-5273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9898 S GLASGOW DR",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840099113",
            "telephone_number": "208-409-5273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "TIANNA",
        "middle_name": "JEAN",
        "credential": "FNP, MSN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-09",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "9666776-8900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Caralyn Freitas, CSW
• Frogley Health & Wellness Center
• Frogley Health and Wellness Center
• Scott H Frogley, CCEP
• Matthew Alton Fuller, PHARMD
• Functional Endocrinology Clinic
• Brady Gagon
• Jeramie D Gaillard, DPT
• Jarom Gabriel Gaitan, CMHC
• Nick Galli, PHD, ACMHC

• Family Nurse Practitioner in South Jordan, UT
• Providers in South Jordan, UT by specialty
• Family Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.