Active NPI
Wu Chang T Marsh-Fullum, LPN
- Licensed Practical Nurse
- Youngstown, OH
National Provider Identifier
1295261634
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- LPN155870.MEDS-IV
- Practice address
- 6790 Lockwood Blvd
Youngstown, OH 44512-3946 - Phone
- (330) 775-6086
- NPI assigned
- May 4, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | LPN155870.MEDS-IV | OH | Primary |
Addresses
Primary practice location
6790 Lockwood Blvd
Youngstown, OH 44512-3946
Mailing address
6790 Lockwood Blvd
Youngstown, OH 44512-3946
Phone (330) 775-6086
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPN155870.MEDS-IV | OH | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1493856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730851200000",
"number": "1295261634",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6790 LOCKWOOD BLVD",
"city": "YOUNGSTOWN",
"state": "OH",
"postal_code": "445123946",
"telephone_number": "330-775-6086"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6790 LOCKWOOD BLVD",
"city": "YOUNGSTOWN",
"state": "OH",
"postal_code": "445123946",
"telephone_number": "330-775-6086"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARSH-FULLUM",
"first_name": "WU CHANG",
"middle_name": "T",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-05-04",
"last_updated": "2024-11-06",
"certification_date": "2024-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "OH",
"license": "LPN155870.MEDS-IV",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Youngstown, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.