Elverl Fully, REGISTER NURSE

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

PN303491 Issued in PA

Practice address

500 Office Center Drive, Suite 400
The Ellison's Nursing Group, LLC
Fort Washington, PA 19034

Phone

(267) 513-1995

Fax

(267) 513-1729

NPI assigned

Oct 26, 2016

Last updated

Apr 28, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1477440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588032000000",
    "number": "1336691245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11800 GRANT RD APT 4203",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774294038",
            "telephone_number": "346-308-0542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 OFFICE CENTER DRIVE, SUITE 400",
            "address_2": "THE ELLISON'S NURSING GROUP, LLC",
            "city": "FORT WASHINGTON",
            "state": "PA",
            "postal_code": "19034",
            "telephone_number": "267-513-1995",
            "fax_number": "267-513-1729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLY",
        "first_name": "ELVERL",
        "credential": "REGISTER NURSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-26",
        "last_updated": "2020-04-28",
        "certification_date": "2020-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "989315",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "PA",
            "license": "PN303491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine M Foster, LCSW
• Shamika Samera Fox
• Katherine Frame
• Michael Peter Frank, M.D.
• Ft. Washington Rehabilitation & Fitness Center, Inc.
• Katherine Gale, M.A., CCC-SLP
• Natalie Gardner, D.D.S
• Nora L Garritt
• Suanne Marshall Garrity, MPT
• Susan Gasteyer, MD

• Licensed Practical Nurse in Fort Washington, PA
• Providers in Fort Washington, PA by specialty
• Licensed Practical Nurse in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2020; 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.