EDWANA DENISE FULLER RN NPI 1760090765

NPI Information

NPI: 1760090765
Provider Name: EDWANA DENISE FULLER, RN
Classification: Registered Nurse - 163WM0705X
Entity Type: Individual

Specialization: Medical-Surgical

Address:
5319 S INDIANA AVE APT 1
CHICAGO, IL
ZIP 60615
Phone: (773) 299-2777
Get Directions

Edwana Denise Fuller, RN is a medical-surgical registered nurse in Chicago, IL. Edwana Denise Fuller, RN NPI is 1760090765. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

5319 S INDIANA AVE APT 1
CHICAGO, IL
ZIP 60615-712
Phone: (773) 299-2777

The enumeration date for this NPI number is 7/16/2020 and was last updated on 7/16/2020.

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	163WM0705X	Registered Nurse	Medical-Surgical	28258565A	INDIANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	28258565A	OTHER	INDIANA	LICENSE NUMBER

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: 4/28/2024

NPI Synchronization or Removal

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