Michelle L Fuller, NPC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

554440 Issued in TX

Practice address

8230 Walnut Hill LN
Ste 220
Dallas, TX 75231-4482

Phone

(214) 750-3646

Fax

(214) 368-1610

NPI assigned

Sep 27, 2005

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184198400000",
    "number": "1689660466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8230 WALNUT HILL LN",
            "address_2": "STE 220",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752314482",
            "telephone_number": "214-750-3646",
            "fax_number": "214-368-1610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8230 WALNUT HILL LN",
            "address_2": "STE 220",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752314482",
            "telephone_number": "214-750-3646",
            "fax_number": "214-368-1610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "MICHELLE",
        "middle_name": "L",
        "credential": "NPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-27",
        "last_updated": "2007-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "554440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Fuller
• Julie Marie Fuller, MD
• Kelcie Denea Fuller
• Lakeshia Rena Fuller, RN
• Lauren Caroline Fuller
• Natasha Lachine Fuller, MBA, QMHP-CS, PSS
• Stephanie Renee Fuller, MS, FNP-C
• Timothy Fuller, MD
• Timothy Brandon Fuller, PRIMARY BENEFICIARY
• Fulllife Medical Supply

• Nurse Practitioner in Dallas, TX
• Providers in Dallas, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.