Lucile Martin Fuller, MA, CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Kure Beach, NC
NPI 1447587381 · NPPES record last updated Nov 13, 2009
Key facts
- NPI
- 1447587381
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 8761 (NC)
- Practice address
- 133 Settlers LN
Kure Beach, NC 28449-3943 - Phone
- (910) 368-7025
- NPI assigned
- Nov 13, 2009
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8761 | NC | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 8761 | NC | Yes |
Addresses
Primary practice location
133 Settlers LN
Kure Beach, NC 28449-3943
Mailing address
133 Settlers LN
Kure Beach, NC 28449-3943
Phone (910) 368-7025
Other names
- Marti Shaw Fuller
Other providers in Kure Beach, NC
All providers in Kure Beach, NC · Speech-Language Pathologist in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 13, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.