MRS. KIMBERLY FULLER (NPI# 1083860324) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083860324 |
| Entity Type | Individual |
| Full Name | MRS. KIMBERLY FULLER |
| Credential | MSN, ACNP - BS |
| Practice Address |
2100 Highway 61 N Vicksburg MS 39183-8211 |
| Practice Telephone | 6018835000 |
| Mailing Telephone | 6018835000 |
| Enumeration Date | 2008-08-18 |
| Last Update Date | 2009-03-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | R853474 | MS | Allopathic & Osteopathic Physicians |
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
R853474 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 07281200 | 05 | |
| LA | 1347574 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528198306 | Kimberly Anne Fuller | Specialist | 1217 Ne Burnside Rd Ste 502, Gresham, OR 97030-5770 | 2007-03-07 |
| 1699101626 | Kimberly Fuller | Case Manager/Care Coordinator | 220 Ruskin Dr, Colorado Springs, CO 80910-2522 | 2013-09-23 |
| 1083053375 | Kimberly A Fuller | Social Worker | 11801 Buckeye Rd, Cleveland, OH 44120-2620 | 2013-06-19 |
| 1033255567 | Kimberly Fuller | Nurse Practitioner | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2007-01-30 |
| 1316047897 | Kimberly Fuller | Physical Therapist | 441 Watertower Cir, Suite 100, Colchester, VT 05446-5801 | 2006-09-24 |
| Street Address |
2100 HIGHWAY 61 N |
| City | VICKSBURG |
| State | MS |
| Zip Code | 39183-8211 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457357691 | Tulio Figarola | Orthopaedic Surgery | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2005-06-22 |
| 1639799430 | Vicksburg Healthcare LLC | Clinical Medical Laboratory | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2020-04-21 |
| 1407481880 | Casey Elaine Collier | Physician Assistant | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2020-03-06 |
| 1124682570 | Kpc Promise Hospital of Vicksburg LLC | Long Term Care Hospital | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2019-04-30 |
| 1144789801 | Laura Lavee Burris | Physician Assistant | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2019-03-12 |
| 1134699192 | Lisa Wamsley | Pharmacist | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2018-12-03 |
| 1619456621 | Kimberly Washington | Physical Therapist | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2018-08-09 |
| 1114459070 | Thulasi Ram Gudi | Internal Medicine | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2017-03-30 |
| 1518403617 | Brett Myers Scruggs | Nurse Anesthetist, Certified Registered | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2017-01-12 |
| 1770933731 | Cesar Luis Merino | Hospitalist | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2016-06-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306217823 | Tracy Curtis | Speech-Language Pathologist | 2100 Us 61, Vicksburg, MS 39183 | 2015-10-09 |
| 1649566894 | The Life Balance Clinic, Behavioral Health Service | Social Worker | 1107 B Openwood St., Vicksburg, MS 39183 | 2011-06-27 |
| 1245428788 | Melanie Joan Waldrop | Nurse Anesthetist, Certified Registered | 2100 Hwy 61n, River Region Medical Center, Vicksburg, MS 39183 | 2007-10-10 |
| 1871714477 | Robert Michael Coleman | Dentist | 2356 Grove Street, Vicksburg, MS 39183 | 2007-05-01 |
| 1942363502 | Visions Physical Therapy | Physical Therapist | 110 Holt Collier Dr, Vicksburg, MS 39183 | 2006-12-18 |
| 1023117991 | Janet S Fisher Dmd Pa | Dentist | 1212 Mission 66, Vicksburg, MS 39183 | 2006-09-21 |
| 1407878663 | Annette Bryant | Social Worker | 1107 Openwood St, Vicksburg, MS 39183 | 2006-07-24 |
| 1932168416 | Promise Hospital of Vicksburg Inc | Long Term Care Hospital | 2100 Highway 61 N Fl 6, Vicksburg, MS 39183 | 2006-03-22 |
| 1164945374 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 2310 Clay St, Vicksburg, MS 39183 | 2017-07-19 |
| 1811244858 | Life Balance Clinic LLC | Social Worker | 1107 Openwood St, Vicksburg, MS 39183 | 2012-08-09 |
| Find all providers in zip 39183 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558302992 | Housecall Practitioners Inc. | Nurse Practitioner | 3420 Wisconsin Ave, Suite 6, Vicksburg, MS 39180-5384 | 2006-06-09 |
| 1063053817 | Brittany Sharda Barnes | Nurse Practitioner | 919 Mission 66, Vicksburg, MS 39183-2751 | 2019-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306450358 | Sara Leanne Davis | Nurse Practitioner | 230 Possum Ridge Rd, Hollandale, MS 38748-3755 | 2020-09-06 |
| 1598385130 | Christy Busby | Nurse Practitioner | 128 Warren St, Pontotoc, MS 38863-1519 | 2020-04-23 |
| 1104459742 | Amanda Paige Michael | Nurse Practitioner | 200 Quail Run, Booneville, MS 38829-9001 | 2020-02-21 |
| 1891328340 | U Matter LLC | Nurse Practitioner | 2440 N Hills St Ste 126, Meridian, MS 39305-2634 | 2020-02-12 |
| 1255978367 | Tanya Haley Mcgee | Nurse Practitioner | 229 Old Yorkville Rd S, Columbus, MS 39702-8440 | 2019-12-08 |
| 1447893888 | Spectrum The Other Clinic | Nurse Practitioner | 2910 Magnolia Pl, Hattiesburg, MS 39402-2428 | 2019-10-17 |
| 1053962068 | Lauren Lanier Guthrie | Nurse Practitioner | 102 Friars Cv, Clinton, MS 39056-3411 | 2019-09-23 |
| 1588212229 | David Buckheister | Nurse Practitioner | 612 Liz Cir, Gulfport, MS 39503-3712 | 2019-08-27 |
| 1821583196 | Amanda Houston Trent | Nurse Practitioner | 4381 S Eason Blvd Ste 203, Tupelo, MS 38801-6557 | 2018-06-28 |
| 1093224446 | Jennifer Hurley | Nurse Practitioner | 2809n Denny Ave, Pascagoula, MS 39581-5301 | 2017-09-28 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.