Keelin Grace Fullen

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

2808 Fox Meadow LN
Jonesboro, AR 72404-9346

Phone

(870) 335-2240

Fax

(870) 931-4457

NPI assigned

Dec 10, 2024

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Learning Center of Northeast Arkansas, Inc.

  • Developmentally Disabled Services Day Training Agency
  • Jonesboro, AR
  • NPI 1376671008
  NPD (past)

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

{
    "created_epoch": "1733788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1386450641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2808 FOX MEADOW LN",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724049346",
            "telephone_number": "870-335-2240",
            "fax_number": "870-931-4457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2808 FOX MEADOW LN",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724049346",
            "telephone_number": "870-335-2240",
            "fax_number": "870-931-4457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLEN",
        "first_name": "KEELIN",
        "middle_name": "GRACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-10",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha M Fry, APRN
• Peteresia A Frymire, LPN
• Aretha Fulcher, LPC
• Fulfilled Life Counseling, LLC
• Karen L Fullen, LCSW
• Jennifer Fullington
• Melanie Donna Fulton, LCSW
• Gwendolyn Furr
• Kyla N Futrell, MS CCC-SLP
• Lakisha Marie Futrell, QBHP

• Speech-Language Pathologist in Jonesboro, AR
• Providers in Jonesboro, AR by specialty
• Speech-Language Pathologist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 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.

Verify at the official NPI Registry.