Deborah Joan Fuller, CNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R42788 Issued in NM

Practice address

7 Municipal Way
Edgewood, NM 87015

Phone

(505) 281-3406

Fax

(505) 286-3329

NPI assigned

Nov 18, 2005

Last updated

Jun 21, 2019By the provider in NPPES

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

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• First Choice Community Healthcare, Inc.

  • Federally Qualified Health Center (FQHC)
  • Edgewood, NM
  • NPI 1962663153
  NPD (past)

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561075200000",
    "number": "1861474207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 CENTRO FAMILIAR BLVD SW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871054592",
            "telephone_number": "505-281-3406",
            "fax_number": "505-286-3329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 MUNICIPAL WAY",
            "city": "EDGEWOOD",
            "state": "NM",
            "postal_code": "87015",
            "telephone_number": "505-281-3406",
            "fax_number": "505-286-3329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "DEBORAH",
        "middle_name": "JOAN",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-18",
        "last_updated": "2019-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NM",
            "license": "R42788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colleen Eungard, LMSW
• Laci Fachini
• First Choice Community Healthcare, Inc.
• Fowler Enterprises, Inc. (East Mountain Physical Therapy)
• Debra Danielle Fromer, LMT
• Elisabeth Leilani Galanis, PROVISIONAL LMHC
• Devin Michelle Garcia, RN
• Sharon D Garnand, MD
• Samantha Marie Garrett
• Bianca Genco-Morrison, LISW

• Nurse Practitioner in Edgewood, NM
• Providers in Edgewood, NM by specialty
• Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2019; 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.