MISTINIQUE J FULLER RN LMP NPI 1457736944

NPI Information

NPI: 1457736944
Provider Name: MISTINIQUE J FULLER, RN, LMP
Classification: Registered Nurse - 163WM1400X
Entity Type: Individual

Specialization: Nurse Massage Therapist (NMT)

Address:
1100 E MAIN ST STE A
OTHELLO, WA
ZIP 99344
Phone: (509) 770-4067
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Mistinique J Fuller, RN, LMP is a nurse massage therapist (nmt) registered nurse in Othello, WA. Mistinique J Fuller, RN, LMP NPI is 1457736944. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1100 E MAIN ST STE A
OTHELLO, WA
ZIP 99344-587
Phone: (509) 770-4067

The enumeration date for this NPI number is 7/25/2015 and was last updated on 10/5/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163WM1400X	Registered Nurse	Nurse Massage Therapist (NMT)	RN60154916	WASHINGTON	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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