FAITH FULLER FNP NPI 1356485015

NPI Information

NPI: 1356485015
Provider Name: FAITH FULLER, FNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
2055 S FREMONT AVE
SUITE 1000
SPRINGFIELD, MO
ZIP 65804
Phone: (417) 820-8099
Get Directions

Faith Fuller, FNP is a family nurse practitioner in Springfield, MO. Faith Fuller, FNP NPI is 1356485015. 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:

2055 S FREMONT AVE
SUITE 1000
SPRINGFIELD, MO
ZIP 65804-206
Phone: (417) 820-8099
Fax: (417) 820-8093

The NPI 1356485015 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 2/16/2007 and was last updated on 4/19/2011.

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	363LF0000X	Nurse Practitioner	Family	052926	MISSOURI	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
1	000080676	MEDICARE PIN	MISSOURI
2	S59184	MEDICARE UPIN	MISSOURI
3	423774801	MEDICAID	MISSOURI
4	837303230	MEDICARE PIN	MISSOURI

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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