Organization Active NPI

Fuller Health & Wellness, LLC

  • Family Nurse Practitioner
  • Fernandina Beach, FL
National Provider Identifier
1699649772
Registry record updated Oct 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
FULLER HEALTH & WELLNESS, LLC
Practice address
910 S 8TH St Ste 205
Fernandina Beach, FL 32034-3771
Phone
(904) 895-6433
Fax
(904) 747-1141
NPI assigned
Oct 2, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Keydella Fuller, APRNNPI 1053855809
Title
Owner
Phone
(904) 895-6433

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

910 S 8TH St Ste 205
Fernandina Beach, FL 32034-3771

Mailing address

910 S 8TH St Ste 205
Fernandina Beach, FL 32034-3771
Phone (904) 895-6433

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1759363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759363200000",
    "number": "1699649772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 S 8TH ST STE 205",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320343771",
            "telephone_number": "904-895-6433",
            "fax_number": "904-747-1141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 S 8TH ST STE 205",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320343771",
            "telephone_number": "904-895-6433",
            "fax_number": "904-747-1141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULLER HEALTH & WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-02",
        "last_updated": "2025-10-02",
        "certification_date": "2025-10-01",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "KEYDELLA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-895-6433",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fernandina Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2025; 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.