HEATHER G FULLMER (NPI# 1285067173) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285067173 |
| Entity Type | Individual |
| Full Name | HEATHER G FULLMER |
| Credential | BS |
| Practice Address |
11921 E Palmer Wasilla Hwy Palmer AK 99645-8833 |
| Mailing Address |
Po Box 1907 Palmer AK 99645-1907 |
| Practice Telephone | 9077452634 |
| Mailing Telephone | 9077452634 |
| Mailing Fax Number | 9077454897 |
| Enumeration Date | 2013-08-14 |
| Last Update Date | 2020-10-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 171M00000X | Case Manager/Care Coordinator | Other Service Providers | ||
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 7610 E. Palmer-wasilla Highway, Palmer, AK 99645 | 9077452634 | 9077454897 |
| Street Address |
11921 E PALMER WASILLA HWY |
| City | PALMER |
| State | AK |
| Zip Code | 99645-8833 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144545989 | Nancy Ann Sellers | Counselor | 11921 E Palmer Wasilla Hwy, Palmer, AK 99645-8833 | 2010-04-05 |
| 1831797323 | Suzanne Feilner | Peer Specialist | 11921 E Palmer Wasilla Hwy, Palmer, AK 99645-8833 | 2020-10-15 |
| 1033716980 | Karina Allen | Peer Specialist | 11921 E Palmer Wasilla Hwy, Palmer, AK 99645-8833 | 2020-10-05 |
| 1811504871 | Chloe Allen | Peer Specialist | 11921 E Palmer Wasilla Hwy, Palmer, AK 99645-8833 | 2020-09-24 |
| 1457968414 | Jeffrey Bowman | Peer Specialist | 11921 E Palmer Wasilla Hwy, Palmer, AK 99645-8833 | 2020-09-24 |
| 1801403860 | Megan Decker | Peer Specialist | 11921 E Palmer Wasilla Hwy, Palmer, AK 99645-8833 | 2020-09-24 |
| 1265047971 | Toccoa Russell | Peer Specialist | 11921 E Palmer Wasilla Hwy, Palmer, AK 99645-8833 | 2020-09-10 |
| 1154936862 | Natalie Tucker | Peer Specialist | 11921 E Palmer Wasilla Hwy, Palmer, AK 99645-8833 | 2020-09-10 |
| 1083229785 | Sabrina Miller | Peer Specialist | 11921 E Palmer Wasilla Hwy, Palmer, AK 99645-8833 | 2020-09-10 |
| 1134734833 | Jordann Reynolds | Counselor | 11921 E Palmer Wasilla Hwy, Palmer, AK 99645-8833 | 2020-09-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295357135 | Kasey M Flintoft | Occupational Therapist | 7200 E. Jim Cottrell Cir, Palmer, AK 99645 | 2020-05-14 |
| 1629601471 | Courtney Randol | Licensed Practical Nurse | 14405 E Pace Dr., Palmer, AK 99645 | 2020-02-20 |
| 1689213092 | Valerie Anne Delaune | Acupuncturist | 9693 N. Little Otter Dr., Palmer, AK 99645 | 2020-01-02 |
| 1003464512 | Alaskan Sunrise Behavioral Health, L.L.C. | Clinic/Center | 14460 E. Pace Dr., Palmer, AK 99645 | 2019-08-28 |
| 1548814718 | Maple Springs of Palmer Snf Holdings, LLC | Skilled Nursing Facility | 12130 E Maple Springs Way, Palmer, AK 99645 | 2019-07-26 |
| 1952868655 | Carla Beth Kelly | Physical Therapist | 7200 Jim Cottrell Circle, Palmer, AK 99645 | 2019-02-28 |
| 1366938375 | Wendy S Page | Behavior Technician | 7200 E Jim Cottrell, Wasilla, AK 99645 | 2018-07-03 |
| 1154845170 | Sarah Elizabeth Gilliland | Occupational Therapist | 7200 E Jim Cottrell Circle, Palmer, AK 99645 | 2017-08-01 |
| 1558885137 | Garland Brooks | Massage Therapist | 1934 Prospect Dr, Palmer, AK 99645 | 2017-07-26 |
| 1386165009 | Sommer Dawn Nielsen | Massage Therapist | 3566 N Mars Ave., Palmer, AK 99645 | 2017-07-03 |
| Find all providers in zip 99645 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831797323 | Suzanne Feilner | Peer Specialist | 11921 E Palmer Wasilla Hwy, Palmer, AK 99645-8833 | 2020-10-15 |
| 1033716980 | Karina Allen | Peer Specialist | 11921 E Palmer Wasilla Hwy, Palmer, AK 99645-8833 | 2020-10-05 |
| 1811504871 | Chloe Allen | Peer Specialist | 11921 E Palmer Wasilla Hwy, Palmer, AK 99645-8833 | 2020-09-24 |
| 1457968414 | Jeffrey Bowman | Peer Specialist | 11921 E Palmer Wasilla Hwy, Palmer, AK 99645-8833 | 2020-09-24 |
| 1801403860 | Megan Decker | Peer Specialist | 11921 E Palmer Wasilla Hwy, Palmer, AK 99645-8833 | 2020-09-24 |
| 1265047971 | Toccoa Russell | Peer Specialist | 11921 E Palmer Wasilla Hwy, Palmer, AK 99645-8833 | 2020-09-10 |
| 1154936862 | Natalie Tucker | Peer Specialist | 11921 E Palmer Wasilla Hwy, Palmer, AK 99645-8833 | 2020-09-10 |
| 1083229785 | Sabrina Miller | Peer Specialist | 11921 E Palmer Wasilla Hwy, Palmer, AK 99645-8833 | 2020-09-10 |
| 1750996542 | Aja Hensley | Peer Specialist | 11921 E Palmer Wasilla Hwy, Palmer, AK 99645-8833 | 2020-09-09 |
| 1639784416 | Heather Copelin | Peer Specialist | 11921 E Palmer Wasilla Hwy, Palmer, AK 99645-8833 | 2020-09-09 |
| Find all providers in PALMER | ||||
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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.