Jennifer Fuller

Primary specialty

School Registered NurseTaxonomy code 163WS0200X

License

RN170543 Issued in AZ

Practice address

9618 N 36TH St
Phoenix, AZ 85028-4938

Phone

(480) 466-6699

NPI assigned

Dec 11, 2015

Last updated

Dec 11, 2015By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1449792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449792000000",
    "number": "1790150084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9618 N 36TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850284938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9618 N 36TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850284938",
            "telephone_number": "480-466-6699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-11",
        "last_updated": "2015-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "AZ",
            "license": "RN170543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fuller Life LLC
• Fuller Theological Seminary
• Aaron Bryce Fuller, COTA
• Bryan L Fuller, O.D.
• Carolyn M Fuller, ND
• Laura Lyn Fuller, SLP
• Lisa Marie Fuller, OTR/L
• Misty Marie Fullerton, D.C.
• Jonathan Daniel Fullner, M.D.
• Shane Amour Fulton, CNA , MD

• School Registered Nurse in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• School Registered Nurse in Arizona

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

Verify at the official NPI Registry.