JESSLYN RENAY FULLERTON ATRIC AEAC NPI 1679233928

NPI Information

  • NPI: 1679233928
  • Provider Name: JESSLYN RENAY FULLERTON, ATRIC, AEAC
  • Classification: Recreation Therapist - 225800000X
  • Entity Type: Individual
  • Address: 1012 ALBEMARLE ST
    BLUEFIELD, WV
    ZIP 24701
  • Phone: (304) 952-6300

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NPI Details

Jesslyn Renay Fullerton, ATRIC, AEAC is a recreation therapist in Bluefield, WV. The provider is a recreation therapist uses recreational activities for intervention in some physical, social or emotional behavior to bring about a desired change in that behavior and promote the growth and development of the patient. Jesslyn Renay Fullerton, ATRIC, AEAC NPI is 1679233928. The provider is registered as an individual entity type and is a single specialty group.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1012 ALBEMARLE ST
BLUEFIELD, WV
ZIP 24701-514
Phone: (304) 952-6300

The enumeration date for this NPI number is 12/28/2021 and was last updated on 12/28/2021.

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
1225800000XRecreation TherapistYes

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: 3/30/2025

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