TINA FULLER (NPI# 1659879096) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659879096 |
| Entity Type | Individual |
| Full Name | TINA FULLER |
| Credential | LPN |
| Practice Address |
340 S Broadview St Cape Girardeau MO 63703-5703 |
| Practice Telephone | 5733320416 |
| Practice Fax Number | 5733352698 |
| Mailing Telephone | 5733320416 |
| Mailing Fax Number | 5733352698 |
| Enumeration Date | 2018-01-31 |
| Last Update Date | 2018-01-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | 2006025670 | MO | Nursing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831688480 | Tina Michele Fuller | Social Worker | 2412 Nw 6th St, Lawton, OK 73507-2211 | 2018-05-08 |
| 1518294693 | Tina Jean Fuller | Counselor | 1101 E Monroe Ave, Mcalester, OK 74501-4815 | 2009-11-10 |
| Street Address |
340 S BROADVIEW ST |
| City | CAPE GIRARDEAU |
| State | MO |
| Zip Code | 63703-5703 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598909939 | Janice L Ruesler | Counselor | 340 S Broadview St, Cape Girardeau, MO 63703-5703 | 2009-04-29 |
| 1750886909 | Mechelle Abernathy | Licensed Practical Nurse | 340 S Broadview St, Cape Girardeau, MO 63703-5703 | 2018-03-29 |
| 1386152973 | Brenda Gause | Registered Nurse | 340 S Broadview St, Cape Girardeau, MO 63703-5703 | 2018-01-17 |
| 1679928501 | Gibson Recovery Center, Inc. | Clinic/Center | 340 S Broadview St, Cape Girardeau, MO 63703-5703 | 2016-04-28 |
| 1669803540 | Center for Relationship Recovery and Counseling | Counselor | 340 S Broadview St, Cape Girardeau, MO 63703-5703 | 2013-12-03 |
| 1689941528 | Jody Petzoldt | Counselor | 340 S Broadview St, Cape Girardeau, MO 63703-5703 | 2011-11-21 |
| 1093097917 | Mary Ann Roberston | Counselor | 340 S Broadview St, Cape Girardeau, MO 63703-5703 | 2011-09-16 |
| 1164719373 | Gibson Recovery Center, Inc. | Counselor | 340 S Broadview St, Cape Girardeau, MO 63703-5703 | 2011-07-08 |
| 1316232069 | John Eugene Nimmo | Counselor | 340 S Broadview St, Cape Girardeau, MO 63703-5703 | 2011-06-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720566102 | Christian Torres Diaz | Dentist | 3070 William Street, Cape Girardeau, MO 63703 | 2018-07-30 |
| 1457758153 | Broadway Ltc, LLC | Pharmacy | 37 Doctors Park Ste 7, Cape Girardeau, MO 63703 | 2014-11-24 |
| 1336562263 | Rachel Speer | Community Health Worker | 20 South Sprigg St, Cape Girardeau, MO 63703 | 2014-01-29 |
| 1245653120 | Mary Wilburn | Community Health Worker | 20 S Spigg, Cape Girardeau, MO 63703 | 2014-01-28 |
| 1831523695 | Saint Francis Medical Center | General Acute Care Hospital | 150 South Mount Auburn Road, Suite 342, Cape Girardeau, MO 63703 | 2013-08-29 |
| 1033481163 | J K Essmyer Medical Services LLC | Clinic/Center | 300 Mt Auburn Rd, Auburn Surgery Center, Inc, Cape Girardeau, MO 63703 | 2012-02-06 |
| 1477867844 | Drx - East Missouri Providers, P.C. | Family Medicine | 465 S Mount Auburn Road, Suite 103, Cape Girardeau, MO 63703 | 2010-07-28 |
| 1346564879 | Richard William Tobey | Family Medicine | 3250 Gordonville Rd Ste 301, Cape Girardeau, MO 63703 | 2010-03-26 |
| 1144413568 | Stephanie Danette Miller | Family Medicine | 817 S. Mount Auburn, Suite 100, Southeast Primary Care, Cape Gerardeau, MO 63703 | 2007-08-20 |
| 1437349305 | Shanaree Mae Muzinich | Radiology | 70 Doctor's Park, Cape Girardeau, MO 63703 | 2007-07-27 |
| Find all providers in zip 63703 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: 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 |
|---|---|---|---|---|
| 1811540966 | Marshell Lane | Licensed Practical Nurse | 760 S Kingshighway St Ste F, Cape Girardeau, MO 63703-7676 | 2019-07-18 |
| 1144794199 | Jessica Ribble | Licensed Practical Nurse | 760 S Kingshighway St Ste F, Cape Girardeau, MO 63703-7676 | 2019-01-13 |
| 1821561945 | Danielle Davidson | Licensed Practical Nurse | 760 S Kingshighway St Ste F, Cape Girardeau, MO 63703-7676 | 2019-01-11 |
| 1184197204 | Loretta Duncan | Licensed Practical Nurse | 760 S Kingshighway St Ste F, Cape Girardeau, MO 63703-7676 | 2019-01-11 |
| 1447734207 | Wendy Hughes | Licensed Practical Nurse | 1112 Linden St, Cape Girardeau, MO 63703-7707 | 2018-09-18 |
| 1710470794 | April Cain | Licensed Practical Nurse | 1112 Linden St, Cape Girardeau, MO 63703-7707 | 2018-06-13 |
| 1750886909 | Mechelle Abernathy | Licensed Practical Nurse | 340 S Broadview St, Cape Girardeau, MO 63703-5703 | 2018-03-29 |
| 1114428802 | Morgan Dawson | Licensed Practical Nurse | 1112 Linden St, Cape Girardeau, MO 63703-7707 | 2018-02-27 |
| 1306345954 | Casey Holzum | Licensed Practical Nurse | 1112 Linden St, Cape Girardeau, MO 63703-7707 | 2018-02-09 |
| 1679071013 | Sherri Mallory | Licensed Practical Nurse | 1112 Linden St, Cape Girardeau, MO 63703-7707 | 2018-01-31 |
| Find all providers in CAPE GIRARDEAU | ||||
| City | CAPE GIRARDEAU |
| Zip Code | 63703 |
Please comment or provide details below to improve the information on TINA FULLER.
| 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.