Fuller Health & Wellness, LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

FULLER HEALTH & WELLNESS, LLC

Practice address

1865 Lime St Ste 103
Fernandina Beach, FL 32034-4779

Phone

(904) 895-6433

Fax

(904) 747-1141

NPI assigned

Oct 2, 2025

Last updated

Oct 7, 2026By the provider in NPPES

Organization subpart

No

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

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Keydella Fuller, APN

  • Family Nurse Practitioner
  • Jacksonville, FL
  • NPI 1053855809
  NPD Authorized official

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

{
    "created_epoch": "1759363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791331200000",
    "number": "1699649772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1865 LIME ST STE 103",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320344779",
            "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": "1865 LIME ST STE 103",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320344779",
            "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": "2026-10-07",
        "certification_date": "2026-10-07",
        "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": []
}

• Stacey Sara Foley, DPT
• Mary Alice Foote, PHARMD
• Virginia Wall Foxworth, LMHC
• Nicole Frazee-Stewart, PTA
• Randall B Fulford, PA-C
• Ivanna Fux Kahn, PA-C
• Caroline Aline Garner
• Steven A Garrett, DMD
• Robin N Gasparini, DNP, APRN, ACNS, BC
• Christina Gaudiana, MS

• Family Nurse Practitioner in Fernandina Beach, FL
• Providers in Fernandina Beach, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2026; 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.