KELLI M. FULLER (NPI# 1952544017) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952544017 |
| Entity Type | Individual |
| Full Name | KELLI M. FULLER |
| Other Name | KELLI M WHITE |
| Credential | ANP-BC |
| Practice Address |
802 Mel Carnahan Dr Ste 215 Hillsboro MO 63050 |
| Mailing Address |
9 Claiborne Place Webster Groves MO 63119 |
| Practice Telephone | 6365432290 |
| Mailing Telephone | 3149209517 |
| Enumeration Date | 2009-04-18 |
| Last Update Date | 2019-07-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 209-003174 | IL | Nursing Service Providers |
| N | 163W00000X | Registered Nurse | 131425 | MO | Nursing Service Providers |
| N | 163W00000X | Registered Nurse | 2533252 | FL | Nursing Service Providers |
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
131425 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5530 Apache Plume Pl, Brighton, CO 806015368 | 3039456419 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760997167 | Kelli Fuller | Occupational Therapy Assistant | 9426 Lima Rd, Fort Wayne, IN 46818-8680 | 2017-12-06 |
| 1831257989 | Kelli Lynne Fuller | Case Manager/Care Coordinator | 4600 S Springhill Jct, Terre Haute, IN 47802-4584 | 2006-12-04 |
| Street Address |
802 MEL CARNAHAN DR STE 215 |
| City | HILLSBORO |
| State | MO |
| Zip Code | 63050 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447799499 | Amy Marie Saak | Registered Nurse | 802 Mel Carnahan Dr Ste 215, Hillsboro, MO 63050 | 2017-02-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942747118 | Jefferson Franklin Community Action Corp | Health Educator | 2 Merchants Dr, Hillsboro, MO 63050 | 2017-01-26 |
| 1073998266 | Lindsey Johnston | Counselor | 351 Main Street, Hillsboro, MO 63050 | 2015-07-29 |
| 1548444797 | Leonard Hughes Co Inc | Eyewear Supplier (Equipment, not the service) | 11339 Hwy 21, Hillsboro, MO 63050 | 2007-12-24 |
| 1275728305 | Shah Enterprises LLC | Health Maintenance Organization | 10640 Highway 21, Hillsboro, MO 63050 | 2007-09-12 |
| 1649487190 | James Reehten | Counselor | 473 Maple, Hillsboro, MO 63050 | 2007-05-16 |
| 1790856268 | Barbara Joyce Becherer | Counselor | 10814 Highway 21, C, Hillsboro, MO 63050 | 2006-11-13 |
| 1740255413 | Jason Fish | Dentist | #4 Hickory Ridge Rd, Suite 100, Hillsboro, MO 63050 | 2006-02-17 |
| 1619963253 | David John Stansfield | Family Medicine | 10279 Business 21, Hillsboro, MO 63050 | 2005-09-20 |
| 1417426933 | Lauren Pritchard | Counselor | 351 Main Street, Hillsboro, MO 63050 | 2018-11-14 |
| 1013116482 | Kerry Ann Greil | Physical Therapy Assistant | 10679 Highway 21, Hillsboro, MO 63050 | 2007-07-16 |
| Find all providers in zip 63050 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407252018 | Jane Heine | Nurse Practitioner | 5276 Glade Chapel Rd, Hillsboro, MO 63050-1929 | 2014-11-10 |
| 1386971323 | Aida Trivic | Nurse Practitioner | 802 Mel Carnahan Dr, Apt 2015, Hillsboro, MO 63050-2427 | 2009-11-12 |
| 1740483551 | Natalya Hasan | Nurse Practitioner | 266 W Main Street, Hillsboro, OR 97123 | 2007-06-08 |
| 1336595131 | Tove Alexandra Silver | Nurse Practitioner | 18650 Nw Cornell Rd Ste 220, Hillsboro, OR 97124-9212 | 2016-05-11 |
| 1184921629 | Beth Anne Doyle | Nurse Practitioner | 266 W Main St, Hillsboro, OR 97123-3961 | 2011-02-18 |
| 1912102393 | Tonya Suzanne Magee | Nurse Practitioner | 1275 N High St, Hillsboro, OH 45133-8273 | 2007-06-18 |
| 1437282555 | Nenice Marie Andrews | Nurse Practitioner | 620 Se Oak St Ste A, Hillsboro, OR 97123-4160 | 2007-03-14 |
| 1487750709 | Kenneth B. Lease | Nurse Practitioner | 19400 Nw Evergreen Pkwy, Hillsboro, OR 97124-7031 | 2006-09-15 |
| 1043315898 | Kathryn Rose Van Beeck | Nurse Practitioner | 19400 Nw Evergreen Pwy, Hillsboro, OR 97124-7031 | 2006-09-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023619285 | Jennifer Lee Speiser | Nurse Practitioner | 12545 Olive Blvd, Saint Louis, MO 63141-6311 | 2020-11-04 |
| 1215537220 | John Franklin Niswonger | Nurse Practitioner | 861 Canyon Trl, Jackson, MO 63755-4001 | 2020-10-28 |
| 1972119014 | Michael Christopher Hassert | Nurse Practitioner | 2290 Graystone Dr, Saint Charles, MO 63303-5159 | 2020-09-22 |
| 1265045264 | Andrea Jane Montgomery | Nurse Practitioner | 444 Honeysuckle Ln, Saint Louis, MO 63119-4521 | 2020-08-28 |
| 1710596424 | Clay Thornburg | Nurse Practitioner | 602 S Home St, Palmyra, MO 63461-1747 | 2020-07-28 |
| 1396362224 | Erin M Kehoe | Nurse Practitioner | 12973 Olive Blvd, Saint Louis, MO 63141-6149 | 2020-06-26 |
| 1508482506 | Matthew Dale Tieskoetter | Nurse Practitioner | 333 S Kirkwood Rd Ste 203, Saint Louis, MO 63122-6161 | 2020-06-25 |
| 1497391924 | Stephnie Michelle Wriedt | Nurse Practitioner | 1605 E Broadway Ste 250, Columbia, MO 65201-8031 | 2019-11-19 |
| 1861033615 | Benedicta Esi | Nurse Practitioner | 6024 Pennsylvania Ave, Saint Louis, MO 63111-2555 | 2019-10-02 |
| 1245896893 | Katina D Smith | Nurse Practitioner | 8820 Mcnulty Dr, Saint Louis, MO 63114-4146 | 2019-05-18 |
| Find all providers with the same taxonomy | ||||
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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.