Kanika Shavon Fuller, BSN, RN, PED-BC

Primary specialty

Pediatric Registered NurseTaxonomy code 163WP0200X

License

26NO11743500 Issued in NJ

Practice address

123 How LN
New Brunswick, NJ 08901-3653

Phone

(732) 448-1000

NPI assigned

May 16, 2025

Last updated

May 16, 2025By 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)

Not enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

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

{
    "created_epoch": "1747353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747353600000",
    "number": "1871384891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 HOW LN",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089013653",
            "telephone_number": "732-448-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 HOW LN",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089013653",
            "telephone_number": "732-448-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "KANIKA",
        "middle_name": "SHAVON",
        "name_prefix": "Ms.",
        "credential": "BSN, RN, PED-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-16",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "NJ",
            "license": "26NO11743500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sherina Roxanne Henson Frischknecht, FNP-C
• Fructus Medical LLC
• Lynn Fryer, APN-C
• Kenji P Fujita, MD
• Mark Patrick Fullenkamp, M.D.
• Maria Jose Funes, MD
• Kahdejah Funnye
• John Andrew Furst Jr.
• Billie S Fyfe Kirschner, MD
• Alissa Gabel, NP-C

• Pediatric Registered Nurse in New Brunswick, NJ
• Providers in New Brunswick, NJ by specialty
• Pediatric Registered Nurse in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 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.