Teria Jo Fuller, RN

Primary specialty

Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X

License

1-091343 Issued in AL

Practice address

908 20TH St S
Birmingham, AL 35205-2610

Phone

(205) 934-0712

NPI assigned

Nov 28, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1511827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511827200000",
    "number": "1255845376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 20TH ST S RM 487",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352052610",
            "telephone_number": "205-934-9715",
            "fax_number": "205-975-8950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "908 20TH ST S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352052610",
            "telephone_number": "205-934-0712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "TERIA",
        "middle_name": "JO",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-28",
        "last_updated": "2017-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "AL",
            "license": "1-091343",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1041C0700X",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Crystal Fuller, CRNP
• Denver Russel Fuller, MD
• Jeffrey J Fuller, MD
• Kyle Fuller
• Maxine Williford Fuller, M.A., LPC, ED.D
• Lisa Putman Fullman
• Ashlee M Fulmer, M.D.
• Benjamin Banks Fulmer, MD
• Tara C Fulmer, CRNA
• Fulton Dental, LLC.

• Adult Psychiatric/Mental Health Registered Nurse in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Adult Psychiatric/Mental Health Registered Nurse in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.