MRS. TEAWKA FULLMORE


Address: 711 Knight Avenue, Waycross, GA 31501-1943
Phone: 9122839423

MRS. TEAWKA FULLMORE (NPI# 1861884215) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1861884215
Entity Type Individual
Full Name MRS. TEAWKA FULLMORE
Credential NP-C
Practice Address 711 Knight Avenue
Waycross
GA 31501-1943
Practice Telephone 9122839423
Practice Fax Number 9122838204
Mailing Telephone 9122839423
Mailing Fax Number 9122838204
Enumeration Date 2015-02-23
Last Update Date 2016-05-26
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 363L00000X Nurse Practitioner RN176193 GA Physician Assistants & Advanced Practice Nursing Providers
Y 363LG0600X Nurse Practitioner
Specialization: Gerontology
RN176193 GA Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
GA MEDICARE GROUP NPI 1144420530 01
GA RAILROAD MEDICARE GROUP ID CG6045 01
GA MEDICARE PTAN 2025I01375 01
GA MEDICARE NPI 1861884215 01
RN STATE LICENSE RN176193 01

Office Location

Street Address 711 KNIGHT AVENUE
City WAYCROSS
State GA
Zip Code 31501-1943

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1962906115 Davenport Health Pa Family Medicine 1401 Cherokee Drive, Waycross, GA 31501 2018-03-22
1962940478 Blake Darren Aldridge Physical Therapy Assistant 401 Preston Street, Waycross, GA 31501 2017-02-03
1669922142 Jebediah S. Christy Dds - Waycross Pllc Dentist 2271 Memorial Dr, Waycross, GA 31501 2016-10-10
1558721944 Jana Kirby Massage Therapist 1599 Knight Ave., Kallman Chiropractic Center, Waycross, GA 31501 2016-02-29
1962877001 Courtney Baldwin Specialist/Technologist, Other 2403 Spurgeon St, Waycross, GA 31501 2015-12-01
1912389784 Grayson Stuart Griffis Dentist 2103 Tebeau St., Waycross, GA 31501 2015-06-29
1730561267 Trishla Amit Desai Internal Medicine Memorial Satilla Health, 1900 Tebeau Street, Waycross, GA 31501 2015-06-20
1316330913 Hanger Prosthetics & Orthotics, Inc. Prosthetic/Orthotic Supplier 512 City Blvd Ste H, Waycross, GA 31501 2015-03-06
1942699079 Jose Ramon Martinez Anesthesiology 701 City Blvd, Waycross, GA 31501 2015-01-13
1023356714 Orthopedics Surgeons of Georgia, LLC Orthopaedic Surgery 2015 Alice Street, Waycross, GA 31501 2013-01-30
Find all providers in zip 31501

Taxonomy Information

Taxonomy Code 363LG0600X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Gerontology

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1740788413 Taylor S Swinea Nurse Practitioner 615a Pendleton St, Waycross, GA 31501-4724 2018-01-29

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1235746009 Jummai Folashade Akinrinmade Nurse Practitioner 5290 Hidden Valley Ln, Cumming, GA 30028-7024 2020-09-25
1396350997 Ellen Allen Nurse Practitioner 8040 Highway 54, Sharpsburg, GA 30277-2112 2020-09-10
1588277867 Saleta Anica Brogdon Nurse Practitioner 10 Muirfield Dr, Covington, GA 30016-6536 2020-08-26
1043828106 Shonkeisha Byrd Nurse Practitioner 1160 Great River Pkwy, Lawrenceville, GA 30045-7015 2020-07-15
1558982272 Irene Kamau Nurse Practitioner 3605 Glenbarrett Ln Ne, Marietta, GA 30066-8509 2020-05-05
1891324133 Branette Young Nurse Practitioner 1120 Lehavre Ct, Hampton, GA 30228-3022 2020-04-08
1851938559 Sandra Holloway Nurse Practitioner 607 Bethany St, Sparks, GA 31647-7139 2019-12-02
1013550508 Monica Smart Mills Nurse Practitioner 8315 Champion Trl, Fairburn, GA 30213-4739 2019-10-28
1063053478 Emily Elizabeth Adams Nurse Practitioner 887 W Marietta St Nw, Atlanta, GA 30318-5252 2019-10-07
1922661800 Dorcus Healthcare Services LLC Nurse Practitioner 105 Greystone Dr, Guyton, GA 31312-5548 2019-04-17
Find all providers with the same taxonomy

Competitor

Search similar providers

City WAYCROSS
Zip Code 31501

Improve Information

Please comment or provide details below to improve the information on MRS. TEAWKA FULLMORE.

Dataset Information

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.

Trending Searches