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KETRA FULLER
NPI 1457879470
Case Manager/Care Coordinator in Shreveport, LA

Active since August 30, 2017
4718 HEARNE AVE, SHREVEPORT, LA 71108(318) 828-1521(800) 795-6388 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 21, 2022, Oct 12, 2020, Jun 20, 2018 and 2 more (5 updates tracked since 2017).

About Ketra Fuller NPPES

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

KETRA FULLER (NPI 1457879470) is an individual case manager/care coordinator provider in Shreveport, Louisiana and active in the NPI registry since August 2017.

NPPES Registry Identity

NPI1457879470
Entity TypeIndividualFemale
Primary Taxonomy171M00000X
Provider Legal NameKETRA FULLER
Location Address4718 HEARNE AVEShreveport, LA 71108
Mailing Address4718 Hearne AveShreveport, LA 71108-2703 · (318) 828-1521 · Fax (810) 079-5638
Phone(318) 828-1521
Fax(800) 795-6388
Sole ProprietorNo
Enumeration DateAugust 30, 2017
Last NPPES UpdateJuly 21, 20225 updates tracked since enumeration
NPPES CertifiedOctober 12, 2020
✔ NPI 1457879470 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCase Manager/Care CoordinatorOther Service Providers
Taxonomy Code171M00000X
Definition
A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee's progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management.
4718 HEARNE AVE, Shreveport, LA 71108
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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.

MS. MALICIA LEVETTE WARREN
Case Manager/Care Coordinator
4718 HEARNE AVE
SHREVEPORT, LA 71108
Caddo Parish (318) 828-1521
MICHALEN DILLARD
Counselor (Mental Health)
4718 HEARNE AVE
SHREVEPORT, LA 71108
Caddo Parish (318) 828-1521
SHAMEAKA MARSHALL
Case Manager/Care Coordinator
4718 HEARNE AVE
SHREVEPORT, LA 71108
Caddo Parish (318) 828-1521
RENALDA STAFFORD
Case Manager/Care Coordinator
4718 HEARNE AVE
SHREVEPORT, LA 71108
Caddo Parish (318) 828-1521
A TOUCH OF MERCY, LLC
Clinic/Center (Mental Health (Including Community Mental Health Center))
4718 HEARNE AVE
SHREVEPORT, LA 71108
Caddo Parish (318) 828-1521
SHANIEKA HADNOTT
Counselor (Mental Health)
4718 HEARNE AVE
SHREVEPORT, LA 71108
Caddo Parish (318) 828-1521
FANNIE BELL
Case Manager/Care Coordinator
4718 HEARNE AVE
SHREVEPORT, LA 71108
Caddo Parish (318) 828-1521
CARLOS BROWN
Case Manager/Care Coordinator
4718 HEARNE AVE
SHREVEPORT, LA 71108
Caddo Parish (318) 828-1521

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 Ketra Fuller's NPI number?

The NPI number for Ketra Fuller is 1457879470. It was assigned to this individual provider in the NPPES registry on August 30, 2017.

Where is Ketra Fuller located?

Ketra Fuller practices at 4718 Hearne Ave, Shreveport, LA 71108. The listed phone number is (318) 828-1521.

What is Ketra Fuller's specialty?

The primary specialty registered for this NPI is Case Manager/Care Coordinator with taxonomy code 171M00000X.

When was this NPI record last updated?

The NPPES record for Ketra Fuller was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.