MRS. NANCY MARIE FULLER (NPI# 1891726337) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891726337 |
| Entity Type | Individual |
| Full Name | MRS. NANCY MARIE FULLER |
| Credential | NP |
| Practice Address |
913 Nw Garden Valley Blvd Va Roseburg Healthcare System Roseburg OR 97471-6523 |
| Practice Telephone | 5414401000 |
| Practice Fax Number | 5414401230 |
| Mailing Telephone | 5414401000 |
| Mailing Fax Number | 5414401230 |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2013-06-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
201050069NP | OR | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
209-003019 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306051222 | Nancy C Fuller | Chiropractor | 104 Robin Hood Dr, Suite 1, Swanton, VT 05488-8003 | 2007-05-14 |
| 1962808964 | Nancy Ann Fuller | Speech-Language Pathologist | 1414 Bowman Rd, Springfield, OH 45502-8826 | 2014-11-18 |
| 1356621403 | Nancy Fuller | Acupuncturist | 5200 Park Rd, Suite 111, Charlotte, NC 28209-3650 | 2011-08-22 |
| 1386968964 | Nancy Unruh Fuller | Registered Nurse | 8830 Long Point Rd, Suite 703, Houston, TX 77055-3040 | 2010-03-25 |
| 1255501318 | Nancy Anne Fuller | Occupational Therapist | 5315 Elliott Dr, Ste 202, Ypsilanti, MI 48197 | 2008-03-05 |
| 1386760718 | Nancy S. Fuller | Psychiatry & Neurology | 700 S Park St, Madison, WI 53715-1830 | 2007-03-21 |
| 1497806491 | Nancy Louise Fuller | Psychologist | 275 Nichols Rd, Fitchburg, MA 01420-1919 | 2007-01-16 |
| 1285601922 | Nancy S Fuller | Internal Medicine | 7241 Lily Ln, Middleton, WI 53562-1075 | 2006-03-01 |
| Street Address |
913 NW GARDEN VALLEY BLVD VA ROSEBURG HEALTHCARE SYSTEM |
| City | ROSEBURG |
| State | OR |
| Zip Code | 97471-6523 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003874546 | Roseburg Vamc | Department of Veterans Affairs (VA) Pharmacy | 913 Nw Garden Valley Blvd, Roseburg, OR 97471-6523 | 2006-05-03 |
| 1114525607 | Kenny Duong | Pharmacist | 913 Nw Garden Valley Blvd, Roseburg, OR 97471-6523 | 2020-10-15 |
| 1588262521 | Ayman Alholail | Pharmacist | 913 Nw Garden Valley Blvd, Roseburg, OR 97471-6523 | 2020-10-12 |
| 1194332528 | Carrie Webster | Psychologist | 913 Nw Garden Valley Blvd, Roseburg, OR 97471-6523 | 2020-09-29 |
| 1619580776 | Shane Gamble | Dietitian, Registered | 913 Nw Garden Valley Blvd, Roseburg, OR 97471-6523 | 2020-08-28 |
| 1942811658 | Shannon O'leary | Pharmacist | 913 Nw Garden Valley Blvd, Roseburg, OR 97471-6523 | 2020-08-14 |
| 1215554209 | Joseph Albrecht | Dietitian, Registered | 913 Nw Garden Valley Blvd, Roseburg, OR 97471-6523 | 2020-06-25 |
| 1609402601 | Crystal Marie Leatherman | Dietitian, Registered | 913 Nw Garden Valley Blvd, Roseburg, OR 97471-6513 | 2020-03-21 |
| 1477189710 | Foua Xiong | Pharmacist | 913 Nw Garden Valley Blvd, Roseburg, OR 97471-6523 | 2020-03-18 |
| 1700425741 | Leah Isip | Pharmacist | 913 Nw Garden Valley Blvd, Roseburg, OR 97471-6523 | 2019-12-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841805660 | Rae Ann Barnes | Pharmacist | 913 Ne Garden Valley Blvd, Pharmacy, Roseburg, OR 97471 | 2020-09-09 |
| 1023651031 | Colton Phillips | Behavioral Analyst | 940 Nw Garden Valley Bvld #104, Roseburg, OR 97471 | 2019-10-22 |
| 1952884876 | Meredith Krugel Lcsw PC | Clinic/Center | 2225 Nw Stewart Parkway Ste 200, Roseburg, OR 97471 | 2018-09-07 |
| 1114456563 | Philip Kaser Family, LLC | Pharmacy | 1175 W. Harvard Avenue, Roseburg, OR 97471 | 2017-06-08 |
| 1053854208 | Icco LLC | Clinic/Center | 1740 Nw Goetz Street, Roseburg, OR 97471 | 2016-11-21 |
| 1770034589 | Evie Jepsen | Case Manager/Care Coordinator | 2700 Stewart Parkway Annex B, Suite 110, Roseburg, OR 97471 | 2016-10-17 |
| 1932551256 | Jonathan Schmidt | Licensed Practical Nurse | 913 Nm Garden Valley Blvd, Va Roseburg Medical Center, Roseburg, OR 97471 | 2016-07-11 |
| 1932580586 | Jeffrey Mark Wareham | Case Manager/Care Coordinator | 2700 Medical Loop, Annex B, Roseburg, OR 97471 | 2015-06-09 |
| 1558784215 | Ginger Jean Thibedeau | Massage Therapist | 3019 Nw Stewart Parkway, Suite 304 #183, Roseburg, OR 97471 | 2014-01-30 |
| 1427303122 | Karishma Parekh | Internal Medicine | 2460 Nw Stewart Pkwy Ste 103, Roseburg, OR 97471 | 2012-07-18 |
| Find all providers in zip 97471 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265502504 | Victoria Dimm Deeks | Nurse Practitioner | 1700 Nw Garden Valley Blvd Ste 201, Roseburg, OR 97471-1636 | 2006-11-08 |
| 1396174652 | Mary Ann Curtiss | Nurse Practitioner | 913 Garden Valley Blvd, Roseburg, OR 97471-6523 | 2013-11-07 |
| 1265445738 | Lindy Sue Gomez | Nurse Practitioner | 913 Nw Garden Valley Blvd, Roseburg, OR 97470-6523 | 2006-08-14 |
| 1558373126 | David J Lampert | Nurse Practitioner | 913 Nw Garden Valley Blvd, Blue Clinic, Roseburg, OR 97470-6523 | 2006-08-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992315972 | Deborah Marie Jones | Nurse Practitioner | 15800 Boones Ferry Rd Ste A6, Lake Oswego, OR 97035-3426 | 2020-08-05 |
| 1184257115 | Joanna Rae Farrell | Nurse Practitioner | 1650 Ne 32nd Ave Apt 425, Portland, OR 97232-3455 | 2020-02-18 |
| 1790241065 | Autumn D Mercer Agnp-c LLC | Nurse Practitioner | 1075 Shayla Ln, Central Point, OR 97502-2995 | 2019-02-12 |
| 1023590841 | Healthy At Home LLC | Nurse Practitioner | 3910 Ne 99th Ave, Portland, OR 97220-3620 | 2018-08-29 |
| 1437648946 | Stephanie Michele Johnson | Nurse Practitioner | 3560 Se 79th Ave, Portland, OR 97206-2372 | 2018-05-09 |
| 1235684937 | Melanie Salvador | Nurse Practitioner | 15352 Sw Oakmont Pl, Tigard, OR 97224 | 2016-08-23 |
| 1003275843 | Catherine Chiaradonna | Nurse Practitioner | 1867 Williams Hwy Ste 226, Grants Pass, OR 97527-5856 | 2016-02-22 |
| 1801266119 | Daniel Dominic Eric Roa | Nurse Practitioner | 5316 N Greeley Ave, Portland, OR 97217-4113 | 2015-09-29 |
| 1538578067 | Karen Lee Warren | Nurse Practitioner | 727 S Wahanna Rd Ste 100, Seaside, OR 97138-7735 | 2014-08-08 |
| 1245579408 | Derek Brent Kordenbrock | Nurse Practitioner | 625 Sw Ramsey Ave Ste A, Grants Pass, OR 97527-5808 | 2013-02-07 |
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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.