Lori Ann Fuller, RN

Primary specialty

Home Health Registered NurseTaxonomy code 163WH0200X

License

110555-30 Issued in WI

Practice address

4088 W Hawthorne Trace Rd Apt 209
Brown Deer, WI 53209-1017

Phone

(414) 759-8582

NPI assigned

Nov 16, 2007

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

Other identifiers 1

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": "1195171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313020800000",
    "number": "1598946642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4088 W HAWTHORNE TRACE RD APT 209",
            "city": "BROWN DEER",
            "state": "WI",
            "postal_code": "532091017",
            "telephone_number": "414-759-8582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4088 W HAWTHORNE TRACE RD APT 209",
            "city": "BROWN DEER",
            "state": "WI",
            "postal_code": "532091017",
            "telephone_number": "414-759-8582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "LORI",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-16",
        "last_updated": "2011-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "WI",
            "license": "110555-30",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39872800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristie J. Fleurimond, MS, LPC
• Kathryn Ford, MS
• Raphael Ford
• Shawanda Ford, MA
• Mackenzie Francis
• Sara Jean Gainey
• Laurence Ganschow, CADC III
• Sabrina Garner
• Paula Gaston, LPN
• Julianne Geddis, MS LPC

• Home Health Registered Nurse in Brown Deer, WI
• Providers in Brown Deer, WI by specialty
• Home Health Registered Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2011; 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.