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MS. LAURA MARIE FULLERTON APN
NPI 1356406144
Nurse Practitioner - Family in Peoria, IL

Active since December 22, 2006
2321 N WISCONSIN AVE, PEORIA, IL 61603(309) 680-7600(309) 681-4681 Get Directions Write a Review

NPPES record last updated: July 25, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ms. Laura Marie Fullerton Apn NPPES

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

MS. LAURA MARIE FULLERTON APN (NPI 1356406144) is an individual family provider in Peoria, Illinois, licensed in Illinois (209-001938) and active in the NPI registry since December 2006.

NPPES Registry Identity

NPI1356406144
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMS. LAURA MARIE FULLERTONCredential: APN
Location Address2321 N WISCONSIN AVEPeoria, IL 61603
Mailing Address2214 N University StPeoria, IL 61604-3221 · (309) 680-7600 · Fax (309) 681-8443
Phone(309) 680-7600
Fax(309) 681-4681
Sole ProprietorNo
Enumeration DateDecember 22, 2006
Last NPPES UpdateJuly 25, 2018
✔ NPI 1356406144 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in IL · 209-001938
2321 N WISCONSIN AVE, Peoria, IL 61603
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Other Names 1

Former Name (1)Laura Green

Other Providers at the Same Location NPPES 17

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

KROGER LIMITED PARTNERSHIP I
Pharmacy (Community/Retail Pharmacy)
2321 N WISCONSIN AVE
PEORIA, IL 61603
Peoria County (309) 688-9456
TERRYL A. POLANIN FNP
Nurse Practitioner (Family)
2321 N WISCONSIN AVE
PEORIA, IL 61603
Peoria County (309) 680-7600
BETHANY JOY WINFREY FERGUSON FNP-BC
Nurse Practitioner
2321 N WISCONSIN AVE
PEORIA, IL 61603
Peoria County (309) 680-7600
MACKENZIE LYNN SMALLEY LCSW
Social Worker (Clinical)
2321 N WISCONSIN AVE
PEORIA, IL 61603
Peoria County (309) 680-7600
KRISTINA LYNN MCCUE APRN
Nurse Practitioner (Psychiatric/Mental Health)
2321 N WISCONSIN AVE
PEORIA, IL 61603
Peoria County (309) 680-7600
CIARA JUNE WHITE APN
Nurse Practitioner (Family)
2321 N WISCONSIN AVE
PEORIA, IL 61603
Peoria County (309) 680-7600
HEARTLAND COMMUNITY HEALTH CLINIC
Clinic/Center (Federally Qualified Health Center (FQHC))
2321 N WISCONSIN AVE
PEORIA, IL 61603
Peoria County (309) 680-7600
MS. MARY JENNIFER SUE MEISTER LCSW
Social Worker (Clinical)
2321 N WISCONSIN AVE
PEORIA, IL 61603
Peoria County (309) 680-7600

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 Laura Fullerton's NPI number?

The NPI number for Laura Fullerton is 1356406144. It was assigned to this individual provider in the NPPES registry on December 22, 2006. The provider is also known as Laura Green.

Where is Laura Fullerton located?

Laura Fullerton practices at 2321 N Wisconsin Ave, Peoria, IL 61603. The listed phone number is (309) 680-7600.

What is Laura Fullerton's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Laura Fullerton was last updated on July 25, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years 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.