Active NPI
Laura Garrard Fuller, APRN
- Family Health Clinical Nurse Specialist
- Lagrange, GA
National Provider Identifier
1669845509
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Health Clinical Nurse Specialist
- License
- RN166518
- Practice address
- 1514 Vernon Rd
Lagrange, GA 30240-4131 - Phone
- (706) 845-3112
- NPI assigned
- Oct 31, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Health Clinical Nurse Specialist | 364SF0001X | RN166518 | GA | Primary |
Addresses
Primary practice location
1514 Vernon Rd
Lagrange, GA 30240-4131
Mailing address
1514 Vernon Rd
Lagrange, GA 30240-4131
Phone (706) 845-3112
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN166518 | GA | MD | Family Health Clinical Nurse Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1446249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1446249600000",
"number": "1669845509",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1514 VERNON RD",
"city": "LAGRANGE",
"state": "GA",
"postal_code": "302404131",
"telephone_number": "706-845-3112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1514 VERNON RD",
"city": "LAGRANGE",
"state": "GA",
"postal_code": "302404131",
"telephone_number": "706-845-3112"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULLER",
"first_name": "LAURA",
"middle_name": "GARRARD",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-10-31",
"last_updated": "2015-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "364SF0001X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist, Family Health",
"state": "GA",
"license": "RN166518",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lagrange, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.