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

Q: 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.

Q: What is Ketra Fuller's specialty?

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

Q: When was this NPI record last updated?

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

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: July 26, 2026.

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

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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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