DANIEL BOSTON FULLER NPI 1629404264

NPI Information

NPI: 1629404264
Provider Name: DANIEL BOSTON FULLER
Classification: Nurse Practitioner - 363LA2100X
Entity Type: Individual

Specialization: Acute Care

Organization: BON SECOURS MEDICAL GROUP HAMPTON ROADS SPECIALTY CARE LLC

PECOS Registration: Yes

Address:
620 JOHN PAUL JONES CIR
PORTSMOUTH, VA
ZIP 23708
Phone: (828) 230-4102
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Daniel Boston Fuller is an acute care nurse practitioner in Portsmouth, VA with 11 years of experience. Daniel Boston Fuller NPI is 1629404264. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

620 JOHN PAUL JONES CIR
PORTSMOUTH, VA
ZIP 23708-111
Phone: (828) 230-4102

The NPI 1629404264 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/14/2013 and was last updated on 2/2/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	364SA2100X	Clinical Nurse Specialist	Acute Care	0024171194	VIRGINIA	No
2	363LA2100X	Nurse Practitioner	Acute Care	0024171194	VIRGINIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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