Candena Marie Fuller

Primary specialty

Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X

License

R085242 Issued in AR

Practice address

10 Canterbury Cir
Batesville, AR 72501-9185

Phone

(870) 307-4610

NPI assigned

Jan 21, 2020

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

Other names 1

• Mrs. Candy Marie Fuller Other name

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": "1579564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579564800000",
    "number": "1992335707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 CANTERBURY CIR",
            "city": "BATESVILLE",
            "state": "AR",
            "postal_code": "725019185",
            "telephone_number": "870-307-4610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 CANTERBURY CIR",
            "city": "BATESVILLE",
            "state": "AR",
            "postal_code": "725019185",
            "telephone_number": "870-307-4610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "CANDENA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-21",
        "last_updated": "2020-01-21",
        "certification_date": "2020-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "AR",
            "license": "R085242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CANDY",
            "last_name": "FULLER",
            "middle_name": "MARIE",
            "prefix": "MRS.",
            "credential": "RN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Cassondra Frey
• Sarah Frisbee
• William J Frisby
• Dana Denise Fryman, FNP-C
• Leah Fugett, BA
• Harold Scott Fuller, OT
• Sarah Fuller, APRN
• Payton Gadberry
• Allison Gage, APRN
• Sharonda Gardner

• Adult Psychiatric/Mental Health Registered Nurse in Batesville, AR
• Providers in Batesville, AR by specialty
• Adult Psychiatric/Mental Health Registered Nurse in Arkansas

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