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MS. KEISHA MUSU FULLY LPN
NPI 1104773803
Licensed Practical Nurse in Staten Island, NY

Active since March 12, 2026
180 PARK HILL AVE APT 5D, STATEN ISLAND, NY 10304(347) 596-1489 Get Directions Write a Review

NPPES record last updated: March 12, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ms. Keisha Musu Fully Lpn NPPES

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

MS. KEISHA MUSU FULLY LPN (NPI 1104773803) is an individual licensed practical nurse in Staten Island, New York, licensed in New York (352421) and active in the NPI registry since March 2026.

NPPES Registry Identity

NPI1104773803
Entity TypeIndividualFemale
Primary Taxonomy164W00000X
Provider Legal NameMS. KEISHA MUSU FULLYCredential: LPN
Location Address180 PARK HILL AVE APT 5DStaten Island, NY 10304-4708
Mailing Address180 Park Hill Ave Apt 5dStaten Island, NY 10304-4708 · (347) 596-1489
Phone(347) 596-1489
Sole ProprietorYes
Enumeration DateMarch 12, 2026
NPPES CertifiedMarch 12, 2026
✔ NPI 1104773803 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers
Taxonomy Code164W00000X
Licenses✔ Licensed in NY · 352421✔ Licensed in NJ · 26NP49873900
Definition
A licensed practical nurse 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.
180 PARK HILL AVE APT 5D, Staten Island, NY 10304
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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 Keisha Fully's NPI number?

The NPI number for Keisha Fully is 1104773803. It was assigned to this individual provider in the NPPES registry on March 12, 2026.

Where is Keisha Fully located?

Keisha Fully practices at 180 Park Hill Ave Apt 5D, Staten Island, NY 10304. The listed phone number is (347) 596-1489.

What is Keisha Fully's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

When was this NPI record last updated?

The NPPES record for Keisha Fully was last updated on March 12, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months 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.