LISA FULLER (NPI# 1932531928) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1932531928 |
Entity Type | Individual |
Full Name | LISA FULLER |
Credential | NP-C |
Practice Address |
2410 Boonville Rd Bryan TX 77808-2226 |
Practice Telephone | 9796904808 |
Practice Fax Number | 9796904809 |
Mailing Telephone | 9796904808 |
Mailing Fax Number | 9796904809 |
Enumeration Date | 2013-08-01 |
Last Update Date | 2015-08-12 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
768961 | TX | Physician Assistants & Advanced Practice Nursing Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1457958746 | Lisa Ellen Fuller | Nutritionist | 3802 Sevierville Pike # 2, Knoxville, TN 37920-4551 | 2020-10-08 |
1801246210 | Lisa Fuller | Registered Nurse | 25 Laurie Ln, Bridgewater, MA 02324-3539 | 2016-06-16 |
1942441092 | Lisa Marie Fuller | Occupational Therapist | 9854 S 43rd Pl, Phoenix, AZ 85044-7528 | 2009-03-19 |
1093838781 | Lisa Marie Fuller | Case Manager/Care Coordinator | 211 Blanchard, Mountain View, AR 72560 | 2007-04-09 |
1609899947 | Lisa Joy Fuller | Optometrist | 505 Retail Way Ste 118, Louisburg, NC 27549-6480 | 2006-07-26 |
1407407372 | Lisa Barry Fuller | Counselor | 1672 Columbia Hwy, Dothan, AL 36303-5434 | 2019-09-23 |
1265927057 | Lisa Ann Fuller | Nurse Practitioner | 8033 Ray Mears Blvd, Knoxville, TN 37919-5458 | 2018-06-25 |
1215430871 | Lisa Fuller | Physical Therapist | 1375 N Main St, Lapeer, MI 48446-1350 | 2018-03-09 |
1760847461 | Lisa Fuller | Registered Nurse | 1600 E Broadway, Columbia, MO 65201-5844 | 2015-12-22 |
1366567398 | Lisa L Fuller | Preventive Medicine | 1720 W Southern Ave, Suite B1-b6, Mesa, AZ 85202-4834 | 2007-03-20 |
Street Address |
2410 BOONVILLE RD |
City | BRYAN |
State | TX |
Zip Code | 77808-2226 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1164634606 | Sybil Jane Taquet | Family Medicine | 2410 Boonville Rd, Bryan, TX 77808-2226 | 2007-05-04 |
1932447604 | Cali Dudgeon | Physician Assistant | 2410 Boonville Rd, Bryan, TX 77808-2226 | 2013-01-30 |
1093940199 | Eric South | Family Medicine | 2410 Boonville Rd, Bryan, TX 77808-2226 | 2009-05-19 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528625605 | Erin Anne Reynoso | Midwife | 10387 Taylor Rd, Bryan, TX 77808 | 2019-05-23 |
1811015878 | Charity A Karpac | Internal Medicine | 2410 Boonville Road, Bryan, TX 77808 | 2007-03-27 |
1760585194 | Aaron Keith Buzzard | Emergency Medicine | 10485 S Fm 2038, Bryan, TX 77808 | 2006-09-07 |
1053834135 | Bv Emergency Physicians, Pllc | Clinic/Center | 2411 Boonville Rd, Bryan, TX 77808 | 2017-07-20 |
1326686114 | Reed Kristynik | Contractor | 2502 Clarks Ln Ste 100, Bryan, TX 77808-1333 | 2019-12-12 |
1033634423 | Julie Ann Stark | Registered Nurse | 3510 Wakefield Dr, Bryan, TX 77808-1430 | 2017-08-07 |
1093958233 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 2350 Boonville Rd, Bryan, TX 77808-2225 | 2009-04-17 |
1700114568 | Thomas Micheal Hohensee | Pharmacist | 2350 Boonville Rd, Bryan, TX 77808-2225 | 2009-12-05 |
1265760292 | Carole L Copeland | Pharmacist | 2350 Boonville Rd, Bryan, TX 77808-2225 | 2009-12-02 |
1710417761 | Brazos Valley Er, LLC | Clinic/Center | 2411 Boonville Rd, Bryan, TX 77808-2231 | 2017-06-13 |
Find all providers in zip 77808 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1194291898 | Jaime Hardy | Nurse Practitioner | 5873 Easterling Dr, Bryan, TX 77808-7830 | 2018-10-19 |
1659859106 | Shameka Crump | Nurse Practitioner | 3201 University Dr E Ste 280, Bryan, TX 77802-3490 | 2018-08-06 |
1063931715 | Laura Lea Pugh | Nurse Practitioner | 2700 E 29th St Ste 235, Bryan, TX 77802-2586 | 2017-09-13 |
1184147068 | Danyel Renae Parker | Nurse Practitioner | 201 E High St Ste 2, Bryan, OH 43506-1773 | 2017-07-21 |
1154872687 | Rosantina Broom | Nurse Practitioner | 3370 S Texas Ave Ste B, Bryan, TX 77802-3127 | 2016-10-19 |
1831648690 | Teresa Dejesus Ramirez | Nurse Practitioner | 1307 Hazel St, Bryan, TX 77803-3633 | 2016-09-22 |
1265701841 | Jennifer M Meaders | Nurse Practitioner | 1716 Briarcrest Dr Ste 300, Bryan, TX 77802-2777 | 2011-12-28 |
1821377300 | Wendy J Seneff | Nurse Practitioner | 2700 E 29th St Ste 325, Bryan, TX 77802-2588 | 2011-08-15 |
1497809719 | Mary Ellen Pate | Nurse Practitioner | 3370 S Texas Ave., Suite G, Bryan, TX 77802-3127 | 2007-01-23 |
1568423259 | James Timothy Gray | Nurse Practitioner | 3841 Sagebriar, Bryan, TX 77802-6107 | 2006-03-31 |
Find all providers in BRYAN |
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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.