Gina M Fullbright, CNP

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

CNP00547 Issued in NM

Practice address

2520 S Telshor Blvd
Las Cruces, NM 88011-4907

Phone

(575) 522-9793

Fax

(575) 532-9019

NPI assigned

Feb 9, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460419200000",
    "number": "1457492795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6310",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880066310",
            "telephone_number": "575-522-9793",
            "fax_number": "575-532-9019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 S TELSHOR BLVD",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880114907",
            "telephone_number": "575-522-9793",
            "fax_number": "575-532-9019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLBRIGHT",
        "first_name": "GINA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2016-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NM",
            "license": "R28306",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NM",
            "license": "CNP00547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "16574052",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Hollyann Fulkerson, RN
• Full Bloom Pediatrics, LLC
• Maynard Darvy Fuller, M.D.
• Monica Anne Fullerton, LISW
• Function Therapy Specialists, Inc
• John Perry Funk, LISW
• Todd Funkhouser, M.D., PH.D

• Women's Health Nurse Practitioner in Las Cruces, NM
• Providers in Las Cruces, NM by specialty
• Women's Health Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2016; 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.