Christine Lee Fullerman, AUDIOLOGIST

Primary specialty

AudiologistTaxonomy code 231H00000X

License

A0917 Issued in OH

Practice address

6614 Southern Blvd
Youngstown, OH 44512-3455

Phone

(330) 743-1168

NPI assigned

Mar 29, 2007

Last updated

Nov 11, 2016By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478822400000",
    "number": "1518086545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 ROSEHEDGE DR",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "445143610",
            "telephone_number": "330-757-9019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6614 SOUTHERN BLVD",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445123455",
            "telephone_number": "330-743-1168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLERMAN",
        "first_name": "CHRISTINE",
        "middle_name": "LEE",
        "credential": "AUDIOLOGIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2016-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OH",
            "license": "A0917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Audiologist in Youngstown, OH
• Providers in Youngstown, OH by specialty
• Audiologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 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.