MARY FULLER (NPI# 1285034058) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285034058 |
| Entity Type | Individual |
| Full Name | MARY FULLER |
| Credential | LPN |
| Practice Address |
495 Congress Ave New Haven CT 06519-1312 |
| Mailing Address |
1 Long Wharf Dr New Haven CT 06511-5991 |
| Practice Telephone | 2037814600 |
| Practice Fax Number | 2037814624 |
| Mailing Telephone | 2037814600 |
| Mailing Fax Number | 2037814624 |
| Enumeration Date | 2014-08-29 |
| Last Update Date | 2017-03-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163W00000X | Registered Nurse | 132485 | CT | Nursing Service Providers |
| N | 164W00000X | Licensed Practical Nurse | 36259 | CT | Nursing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 004082260 | 05 | |
| CT | 008001325 | 05 | |
| CT | 008022622 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740751015 | Mary Fuller | Home Health Aide | 3043 N 29th St., Milwaukee, WI 53209 | 2018-12-16 |
| 1295052009 | Mary Elizabeth Fuller | Physical Therapist | 300 N Virginia St, Port Lavaca, TX 77979-3449 | 2010-05-03 |
| 1013113133 | Mary Ann Fuller | Dietitian, Registered | 415 Springtree Rd, Lake Dallas, TX 75065-2392 | 2007-06-25 |
| 1902938525 | Mary E Fuller | Marriage & Family Therapist | 835 Sorrelwood Ct, Westlake Village, CA 91361-1840 | 2007-03-09 |
| 1538130984 | Mary Margaret Fuller | Counselor | 40347 Us Highway 19 N Ste 103, Tarpon Springs, FL 34689-4841 | 2006-02-01 |
| 1497364053 | Mary Fuller | Preventive Medicine | 110 N Burr Blvd, Kewanee, IL 61443-2214 | 2020-07-29 |
| 1639723240 | Mary Cassandra Fuller | Nurse Practitioner | 4499 Medical Dr, San Antonio, TX 78229-3735 | 2019-07-31 |
| 1326503707 | Mary Alise Fuller | Technician | 3030 30th St Se, Washington, DC 20020-1674 | 2019-02-09 |
| 1245775428 | Mary N. Fuller | Nurse Practitioner | 109 Daniel Dr, Danville, KY 40422 | 2016-12-27 |
| 1689913774 | Mary Ellen Fuller | Occupational Therapist | 1 Freedom Way, Active Duty Rehab Unit (27), Augusta, GA 30904-6258 | 2013-02-08 |
| Street Address |
495 CONGRESS AVE |
| City | NEW HAVEN |
| State | CT |
| Zip Code | 06519-1312 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871667188 | Carmela Cortese | Social Worker | 495 Congress Ave, New Haven, CT 06519-1312 | 2006-11-20 |
| 1720690142 | Myriam Milfort | Counselor | 495 Congress Ave, New Haven, CT 06519-1312 | 2020-08-18 |
| 1982243341 | Breann Artes | Counselor | 495 Congress Ave, New Haven, CT 06519-1312 | 2020-01-03 |
| 1740753367 | Toni-michelle Storlazzi | Counselor | 495 Congress Ave, New Haven, CT 06519-1312 | 2019-01-07 |
| 1366922312 | Rhonda Watson-dejesus | Counselor | 495 Congress Ave, New Haven, CT 06519-1312 | 2018-08-20 |
| 1013447523 | Mukhtar M Nalado | Counselor | 495 Congress Ave, New Haven, CT 06519-1312 | 2017-06-16 |
| 1447799051 | Ebony Langston | Counselor | 495 Congress Ave, New Haven, CT 06519-1312 | 2017-02-15 |
| 1760928519 | Sharnelle Branyon | Counselor | 495 Congress Ave, New Haven, CT 06519-1312 | 2017-01-17 |
| 1588027403 | Ryan Wade | Psychiatry & Neurology | 495 Congress Ave, New Haven, CT 06519-1312 | 2016-03-29 |
| 1437518404 | Frederick Coburn | Social Worker | 495 Congress Ave, New Haven, CT 06519-1312 | 2016-02-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255819348 | Jordan Ficocelli | Nurse Practitioner | 800 Howard Ave # 2, New Haven, CT 06519 | 2018-08-01 |
| 1780123414 | Claire Louise Hardin | General Acute Care Hospital | 95 Howard Ave, New Haven, CT 06519 | 2017-02-14 |
| 1467809137 | Ana Laura Vives-rodriguez | Student in an Organized Health Care Education/Training Program | 800 Howard Avenue, Lower Level, Yale Physicians Building, New Haven, CT 06519 | 2016-05-23 |
| 1346607785 | Amanda Kayte Corcoran | Advanced Practice Midwife | 40 Prince St., Suite 207, New Haven, CT 06519 | 2016-01-15 |
| 1720491905 | Sara Harcharik Perkins | Dermatology | 2 Church St S Ste 305, New Haven, CT 06519 | 2014-06-05 |
| 1194136713 | Krishan Ratilal Jethwa | Radiology | 35 Park St Ste Ll507, New Haven, CT 06519 | 2014-05-16 |
| 1235549353 | Brandon Michael Kitay | Psychiatry & Neurology | 184 Liberty St # Lv108, New Haven, CT 06519 | 2014-04-28 |
| 1649526617 | Yale New Haven Hospital | Student in an Organized Health Care Education/Training Program | 330 Cedar St Fmb 107, Yale New Haven Hospital, Dept of Surgery, New Haven, CT 06519 | 2012-07-27 |
| 1669736765 | Mayanka Tickoo | Internal Medicine | 300 Cedar St Fl 4, New Haven, CT 06519 | 2012-07-03 |
| 1730441627 | Judith A Ross | Physical Therapist | 18 Tower Lane, Tower One Tower East, New Haven, CT 06519 | 2012-06-15 |
| Find all providers in zip 06519 | ||||
| Taxonomy Code | 163W00000X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| (1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.’s assist patient in recovering and maintaining their physical or mental health. They assist physicians during treatments and examinations and administer medications. (2) A provider who is trained and educated in a formal nursing education program at an accredited school of nursing, passes a national certification examination, and is licensed by the state to practice nursing. The individual provides nursing services to patients or clients in areas such as health promotion, disease prevention, acute and chronic care and restoration and maintenance of health across the life span. |
| Notes: Sources: (2) American Nurses Association, American Nurses Credentialing Center, 1996 Certification Catalogue, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437769510 | Michelle F Vallejos | Registered Nurse | 9653 Dension Ln, New Haven, IN 46774-3140 | 2020-08-04 |
| 1881213346 | Sarah Bleicher | Registered Nurse | Yale Health, 55 Lock St, New Haven, CT 06511 | 2020-04-14 |
| 1346869583 | Lyndsay Dematteo | Registered Nurse | 175 Nicoll St, New Haven, CT 06511-2623 | 2020-04-08 |
| 1225669724 | Ariel Zak | Registered Nurse | 65 Dwight St Apt 76, New Haven, CT 06511-5352 | 2020-02-03 |
| 1184275430 | Jill Nadine Langan | Registered Nurse | 46 Prince St Ste 408, New Haven, CT 06519-1600 | 2019-09-26 |
| 1841840956 | Adin Kreiger-benson | Registered Nurse | 68 Bishop St Apt 1, New Haven, CT 06511-3932 | 2019-09-19 |
| 1548743263 | Pamela Ehle | Registered Nurse | 12214 Parent Rd, New Haven, IN 46774-9707 | 2018-09-09 |
| 1902382203 | Rachel Nelson | Registered Nurse | 32485 Thatcher St, New Haven, MI 48048-2996 | 2018-07-19 |
| 1801331996 | Tami Pollock | Registered Nurse | 961 Claddagh Ln, New Haven, MO 63068-2729 | 2016-12-27 |
| 1871044271 | Jeenu Mary Zacharias | Registered Nurse | 333 Cedar St, Tmp3, Yale University, Department of Anesthesiology, New Haven, CT 06520-8051 | 2016-10-20 |
| Find all providers in NEW HAVEN | ||||
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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.