Breanna Fuller

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

351113 Issued in TX

Practice address

30604 Setterfeld Cir
Boerne, TX 78015-2108

Phone

(210) 897-9343

NPI assigned

Mar 13, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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": "1552435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1891254504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30604 SETTERFELD CIR",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780152108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30604 SETTERFELD CIR",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780152108",
            "telephone_number": "210-897-9343"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7710 W Ih 10",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782304711",
            "country_code": "US",
            "telephone_number": "210-377-3355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULLER",
        "first_name": "BREANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-13",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "351113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tammy Fua, LVN
• Carol Fuentes
• David Fuentes, MD
• Fulcrum Health Care Consultants
• Full Smile Dental Boerne Orthodontics, PLLC
• Furs Health PLLC
• Matthew Denton Gabel, DC
• Melissa Marie Gabourie, PHARM D
• Galli Family Chiropractic PA
• Carlo Dan Galli, D.C.

• Licensed Vocational Nurse in Boerne, TX
• Providers in Boerne, TX by specialty
• Licensed Vocational Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; 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.