DR. CASEY ANNA FULLER (NPI# 1568997757) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568997757 |
| Entity Type | Individual |
| Full Name | DR. CASEY ANNA FULLER |
| Credential | PHMNP-BC |
| Practice Address |
5102 W Campbell Ave Phoenix AZ 85031-1703 |
| Practice Telephone | 6026551000 |
| Mailing Telephone | 6026555500 |
| Enumeration Date | 2017-04-25 |
| Last Update Date | 2020-07-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WP0808X |
Registered Nurse Specialization: Psych/Mental Health |
238135 | AZ | Nursing Service Providers |
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
113250 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
5102 W CAMPBELL AVE |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85031-1703 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356332084 | Gregory L Bandy | Emergency Medicine | 5102 W Campbell Ave, Phoenix, AZ 85031-1703 | 2005-11-02 |
| 1669936472 | Maricopa County Special Health Care District | Pharmacy | 5102 W Campbell Ave, Phoenix, AZ 85031-1703 | 2019-01-25 |
| 1710489034 | Nicole M Davis | Nurse Practitioner | 5102 W Campbell Ave, Phoenix, AZ 85031-1703 | 2018-03-02 |
| 1205344066 | Pai-han Arthur Yeh | Nurse Practitioner | 5102 W Campbell Ave, Phoenix, AZ 85031-1703 | 2018-01-15 |
| 1083156319 | Amanda Horton | Nurse Practitioner | 5102 W Campbell Ave, Phoenix, AZ 85031-1703 | 2016-11-17 |
| 1417301490 | Chad Van Pelt | Psychiatry & Neurology | 5102 W Campbell Ave, Phoenix, AZ 85031-1703 | 2016-04-15 |
| 1962856088 | Jacob Demenna | Psychiatry & Neurology | 5102 W Campbell Ave, Phoenix, AZ 85031-1703 | 2016-04-14 |
| 1346603578 | Michelle Vita Sipe | Psychiatry & Neurology | 5102 W Campbell Ave, Phoenix, AZ 85031-1703 | 2016-04-04 |
| 1164817854 | Zhi Yuan Wu | Psychiatry & Neurology | 5102 W Campbell Ave, Phoenix, AZ 85031-1703 | 2015-03-31 |
| 1306251004 | Jessica Ellis | Physician Assistant | 5102 W Campbell Ave, Phoenix, AZ 85031-1703 | 2014-06-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508256629 | Jessica Watson | Physical Therapy Assistant | 4110 N 108th Ave, Suite 103, Phoenix, AZ 85031 | 2015-01-27 |
| 1043518707 | Lisette V Hill | Nurse Practitioner | 3802 N 53rd Avenue, Suite 160, Phoenix, AZ 85031 | 2011-03-04 |
| 1760785778 | Unlimited Smiles | Dentist | 4805 West Thomas, Suite #a, Phoenix, AZ 85031 | 2010-12-13 |
| 1043526817 | Atul J Amin | Pharmacist | 5102 W Indian School Rd (walgreens), Phoenix, AZ 85031 | 2010-08-31 |
| 1396064663 | Akdhc, LLC | Internal Medicine | 4524 N Maryvale Parkway, Akdhc, LLC - Maryvale, Ste 160, Phoenix, AZ 85031 | 2010-05-25 |
| 1629397583 | Scott Anthony Effinger | Pharmacist | 4616 N. 51st Avenue, Suite 203, Phoenix, AZ 85031 | 2010-05-18 |
| 1912237397 | Albert Potter | Counselor | 5043 W. Campbell Ave., Phoenix, AZ 85031 | 2010-01-06 |
| 1649434887 | Mahmoud Azmi Mahafzah | Internal Medicine | 5251 W Campbell Ave Ste 204, Phoenix, AZ 85031 | 2008-07-16 |
| 1427253335 | Evelyn Tan Omana-roldan | Family Medicine | 4700 N. 51st Avenue, Suite 1, Phoenix, AZ 85031 | 2007-06-19 |
| 1255416103 | Chicanos Por La Causa Inc | Clinic/Center | 4602 W. Indian School Rd., Cplc Centro De La Familia, Phoenix, AZ 85031 | 2006-10-26 |
| Find all providers in zip 85031 | ||||
| Taxonomy Code | 163WP0808X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003424771 | Emetu Onuma | Registered Nurse | 2745 W Jessica Ln, Phoenix, AZ 85041-4442 | 2020-07-20 |
| 1518506864 | Latanya Darden | Registered Nurse | 3327 W La Salle St, Phoenix, AZ 85041-3491 | 2020-01-04 |
| 1164067922 | Brandon Webster | Registered Nurse | 4601 E Karen Dr, Phoenix, AZ 85032-4811 | 2019-11-15 |
| 1598259467 | Luis F Fong | Registered Nurse | 3620 N. 3rd Street, Phoenix, AZ 85012 | 2018-06-14 |
| 1265812135 | Andrea Pupillo | Registered Nurse | 10220 N 31st Ave Ste 101, Phoenix, AZ 85051-9562 | 2015-06-04 |
| 1861030140 | Leandre U Rwasine | Registered Nurse | 9014 S Central Ave, Phoenix, AZ 85042-8304 | 2019-12-17 |
| 1306492046 | Christian M Azode | Registered Nurse | 1800 E Van Buren St, Phoenix, AZ 85006-3742 | 2019-08-16 |
| 1629532387 | Jamie Lynn Crumley | Registered Nurse | 3620 N 3rd St, Phoenix, AZ 85012-2020 | 2019-01-28 |
| 1235609637 | Elizabeth Anne Howe | Registered Nurse | 16620 N 40th St Ste H4, Phoenix, AZ 85032-3399 | 2018-11-28 |
| 1285122408 | Carolyn Wendy Tellez | Registered Nurse | 16620 N 40th St Ste H4, Phoenix, AZ 85032-3399 | 2018-04-23 |
| Find all providers in PHOENIX | ||||
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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.