Terri Fuller, APN

Primary specialty

Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X

License

26NN07087000 Issued in NJ

Practice address

694 RT 15 S. Plaza
Suite 105
Lake Hopatcong, NJ 07849

Phone

(973) 288-1550

Fax

(973) 288-1552

NPI assigned

Jul 13, 2006

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

Other identifiers 2

Other names 1

• Ms. Terri M Fuller Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Interoperability endpoints

• Direct secure messaging: terri.fuller.1@17698.direct.athenahealth.com

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563235200000",
    "number": "1982629432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "694 STATE ROUTE 15 S",
            "address_2": "SUITE 105",
            "city": "LAKE HOPATCONG",
            "state": "NJ",
            "postal_code": "078492249",
            "telephone_number": "973-288-1550",
            "fax_number": "973-288-1552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "694 RT 15 S. PLAZA",
            "address_2": "SUITE 105",
            "city": "LAKE HOPATCONG",
            "state": "NJ",
            "postal_code": "07849",
            "telephone_number": "973-288-1550",
            "fax_number": "973-288-1552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "TERRI",
        "name_prefix": "Ms.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2019-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "NJ",
            "license": "26NN07087000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVANCED WOMEN'S HEALTH, LLC GROUP PIN",
            "identifier": "1891096848",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TFNP,INC",
            "identifier": "814813177",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERRI",
            "last_name": "FULLER",
            "middle_name": "M",
            "prefix": "MS.",
            "credential": "APN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Obstetrics & Gynecology Nurse Practitioner in Lake Hopatcong, NJ
• Providers in Lake Hopatcong, NJ by specialty
• Obstetrics & Gynecology Nurse Practitioner in New Jersey

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