Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MRS. SHANNON FULTZ NP
NPI 1023601069
Nurse Practitioner in Providence, RI

Active since February 19, 2021
593 EDDY ST, PROVIDENCE, RI 02903(401) 793-9166(401) 444-2788 Get Directions Write a Review

NPPES record last updated: July 29, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 29, 2026, Feb 19, 2021 (2 updates tracked since 2021).

About Mrs. Shannon Fultz Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. SHANNON FULTZ NP (NPI 1023601069) is an individual nurse practitioner in Providence, Rhode Island, licensed in Rhode Island (APRN02454) and active in the NPI registry since February 2021.

NPPES Registry Identity

NPI1023601069
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameMRS. SHANNON FULTZCredential: NP
Location Address593 EDDY STProvidence, RI 02903-4923
Mailing Address15 La Salle SqProvidence, RI 02903-1814 · (401) 444-6779 · Fax (401) 444-6912
Fax(401) 444-2788
Sole ProprietorNo
Enumeration DateFebruary 19, 2021
Last NPPES UpdateJuly 29, 20262 updates tracked since enumeration
NPPES CertifiedJuly 29, 2026
NPI 1023601069 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License Licensed in RI · APRN02454
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Also ListedNurse Practitioner · Acute CareTaxonomy 363LA2100X · License APRN02454 (RI)
593 EDDY ST, Providence, RI 02903

Other Names 1

Former Name (1)Shannon Gill

Other Identifiers 1

OtherAPRN02454RI · State

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Anesthesiology
593 EDDY ST, APC 6
PROVIDENCE, RI 02903
Surgery
593 EDDY ST
PROVIDENCE, RI 02903
General Acute Care Hospital
593 EDDY ST, MAIN 4
PROVIDENCE, RI 02903
Pathology (Anatomic Pathology & Clinical Pathology)
593 EDDY ST
PROVIDENCE, RI 02903
Psychiatry & Neurology (Neurology)
593 EDDY ST
PROVIDENCE, RI 02903
Student in an Organized Health Care Education/Training Program
593 EDDY ST
PROVIDENCE, RI 02903
Physician Assistant
593 EDDY ST
PROVIDENCE, RI 02903
Student in an Organized Health Care Education/Training Program
593 EDDY ST
PROVIDENCE, RI 02903

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shannon Fultz's NPI number?

The NPI number for Shannon Fultz is 1023601069. It was assigned to this individual provider in the NPPES registry on February 19, 2021. The provider is also known as Shannon Gill.

Where is Shannon Fultz located?

Shannon Fultz practices at 593 Eddy St, Providence, RI 02903. The listed phone number is (401) 793-9166.

What is Shannon Fultz's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

When was this NPI record last updated?

The NPPES record for Shannon Fultz was last updated on July 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.