Creseta E Fuller, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN9541126 Issued in FL

Practice address

Elbowoods Memorial Health Centr
1058 College Drive
New Town, ND 58763

Phone

(701) 627-7904

Fax

(701) 627-2809

NPI assigned

Dec 12, 2023

Last updated

Dec 12, 2023By the provider in NPPES

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

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": "1702339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1386412138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 VILLAGE BLVD STE 260",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334091963",
            "telephone_number": "877-687-7399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ELBOWOODS MEMORIAL HEALTH CENTR",
            "address_2": "1058 COLLEGE DRIVE",
            "city": "NEW TOWN",
            "state": "ND",
            "postal_code": "58763",
            "telephone_number": "701-627-7904",
            "fax_number": "701-627-2809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "CRESETA",
        "middle_name": "E",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-12",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9541126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yujia Fan
• Sierra Dawn Flying Horse
• Gregory L Fondong, PHARMACIST
• Joni Foote
• Fort Berthold IHS Health Center Pharmacy
• Juan Felix Gaido, MD
• Eva Garreau
• Sharlene Gjermundson, RN
• Kyonia Hale
• Sunny Hall, RN

• Registered Nurse in New Town, ND
• Providers in New Town, ND by specialty
• Registered Nurse in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2023; 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.