GRETCHEN L FULKERSON (NPI# 1720356256) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720356256 |
| Entity Type | Individual |
| Full Name | GRETCHEN L FULKERSON |
| Credential | APRN |
| Practice Address |
874 American Pacific Dr Henderson NV 89014-8800 |
| Mailing Address |
1801 W Olympic Blvd # 2265 Pasadena CA 91199-0001 |
| Practice Telephone | 7027774809 |
| Enumeration Date | 2011-12-12 |
| Last Update Date | 2020-10-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
APRN002622 | NV | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
874 AMERICAN PACIFIC DR |
| City | HENDERSON |
| State | NV |
| Zip Code | 89014-8800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013919349 | Jacqueline Randa | Physical Therapist | 874 American Pacific Dr, Henderson, NV 89014-8800 | 2005-05-31 |
| 1952926297 | Dana Shepherd | Physician Assistant | 874 American Pacific Dr, Henderson, NV 89014-8800 | 2020-06-12 |
| 1558999888 | Jino Soriano | Student in an Organized Health Care Education/Training Program | 874 American Pacific Dr, Henderson, NV 89014-8800 | 2020-03-31 |
| 1083279442 | Sarah Peralta | Behavior Technician | 874 American Pacific Dr, Henderson, NV 89014-8800 | 2019-05-01 |
| 1871082511 | Robert Wimmer | Physician Assistant | 874 American Pacific Dr, Henderson, NV 89014-8800 | 2018-05-08 |
| 1093217507 | Tiffany Ann Finnegan | Behavior Technician | 874 American Pacific Dr, Henderson, NV 89014-8800 | 2018-03-01 |
| 1801303326 | Adam Volker | Behavioral Analyst | 874 American Pacific Dr, Henderson, NV 89014-8800 | 2018-01-05 |
| 1497268791 | Patrick Allen Leytham | Technician, Other | 874 American Pacific Dr, Henderson, NV 89014-8800 | 2017-11-08 |
| 1316475072 | Cynthia Lau | Occupational Therapist | 874 American Pacific Dr, Henderson, NV 89014-8800 | 2017-05-25 |
| 1497209134 | Teresa Renee Edwards | Behavioral Analyst | 874 American Pacific Dr, Henderson, NV 89014-8800 | 2016-08-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447857024 | Sudheer J. Surpure, Md, Dds, Inc. | Oral & Maxillofacial Surgery | Grand Canyon Oral and Facial Surgery, 1600 W. Sunset Road, Suite B, Henderson, NV 89014 | 2020-10-06 |
| 1386271740 | Fibonacci Services LLC | Counselor | 2920 N. Green Valley Pkwy, Bulding 8 & Suite 812, Henderson, NV 89014 | 2020-03-25 |
| 1508409145 | Facial Expressions Presented By K. Thomas | Home Infusion | 1520 W. Sunset Rd. Ste 130, #205, Henderson, NV 89014 | 2019-10-27 |
| 1235794595 | Marquise D Dennis | Prosthetist | 1520 W. Sunset Rd, Henderson, NV 89014 | 2019-05-02 |
| 1609359165 | Kenisha Voncille Thomas | Family Medicine | 1520 W Sunset Rd Ste 130, Henderson, NV 89014 | 2018-09-11 |
| 1841716727 | Logan Bretney | Physical Therapist | 400 S Stephanie St, Suite 310, Building 1, Henderson, NV 89014 | 2017-08-22 |
| 1912421280 | Alan Joseph Sevy | Dentist | 1485 W Warm Springs Rd Ste 101, Henderson, NV 89014 | 2017-07-28 |
| 1659805307 | Ann Marie Echevarria | Behavior Technician | 2551 N Green Valley Parkway, 410a, Henderson, NV 89014 | 2017-04-19 |
| 1366838997 | Ladwana Retic, Lcsw LLC | Case Management | 1514 Tree Top Ct, Henderson, NV 89014 | 2015-04-10 |
| 1073958393 | Ashlyn Call | Physician Assistant | 1397 Galleria Dr Ste 100, Henderson, NV 89014 | 2013-04-30 |
| Find all providers in zip 89014 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083227870 | Raven Nicole Pirtle | Nurse Practitioner | 1245 Glenshiel Dr, Henderson, KY 42420-2529 | 2020-08-31 |
| 1811509359 | Kristi Lynn Navarette | Nurse Practitioner | 3058 Hushed Sonnet Ave, Henderson, NV 89044-0558 | 2020-08-17 |
| 1275143711 | Kristyn Cisilino | Nurse Practitioner | 2556 Chateau Clermont St, Henderson, NV 89044-0459 | 2020-08-07 |
| 1972113363 | Rini Susan Mathews | Nurse Practitioner | 3396 Dalmore St, Henderson, NV 89044-1722 | 2020-07-31 |
| 1033735014 | Savinder Kaur Virk | Nurse Practitioner | 10747 Shasta Glow Ct, Henderson, NV 89052-8691 | 2020-06-24 |
| 1811517022 | D Ana Curtis | Nurse Practitioner | 815 Chameleon Star Ave, Henderson, NV 89015-2411 | 2020-04-17 |
| 1275169013 | Joyce Carlos Damiano | Nurse Practitioner | 2839 Saint Rose Pkwy Ste 130, Henderson, NV 89052-4849 | 2020-03-12 |
| 1568008878 | Oliver Torrefranca | Nurse Practitioner | 910 Monte Etna Ave, Henderson, NV 89012-2654 | 2019-11-21 |
| 1568006864 | Melissa Ann Ridella | Nurse Practitioner | 1748 W Horizon Ridge Pkwy, Henderson, NV 89012-4833 | 2019-10-30 |
| 1245881317 | Edith Borgert | Nurse Practitioner | 3039 W Horizon Ridge Pkwy Ste 110, Henderson, NV 89052-4193 | 2019-09-20 |
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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.