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TINA FULLER LPN
NPI 1659879096
Licensed Practical Nurse in Cape Girardeau, MO

Active since January 31, 2018
340 S BROADVIEW ST, CAPE GIRARDEAU, MO 63703(573) 332-0416(573) 335-2698 Get Directions Write a Review

NPPES record last updated: February 7, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Tina Fuller Lpn NPPES

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

TINA FULLER LPN (NPI 1659879096) is an individual licensed practical nurse in Cape Girardeau, Missouri, licensed in Missouri (2006025670) and active in the NPI registry since January 2018.

NPPES Registry Identity

NPI1659879096
Entity TypeIndividualFemale
Primary Taxonomy164W00000X
Provider Legal NameTINA FULLERCredential: LPN
Location Address340 S BROADVIEW STCape Girardeau, MO 63703-5703
Mailing Address8206 Fendale DrSaint Louis, MO 63123-3304 · (573) 944-4271
Phone(573) 332-0416
Fax(573) 335-2698
Sole ProprietorNo
Enumeration DateJanuary 31, 2018
Last NPPES UpdateFebruary 7, 2026
NPPES CertifiedFebruary 7, 2026
✔ NPI 1659879096 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers
Taxonomy Code164W00000X
License✔ Licensed in MO · 2006025670
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.
340 S BROADVIEW ST, Cape Girardeau, MO 63703
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Other Providers at the Same Location NPPES 8

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

MS. MARY ANN ROBERSTON M.A.
Counselor (Professional)
340 S BROADVIEW ST
CAPE GIRARDEAU, MO 63703
Cape Girardeau County (573) 332-0613
GIBSON CENTER FOR BEHAVIORAL CHANGE
Counselor (Mental Health)
340 S BROADVIEW ST
CAPE GIRARDEAU, MO 63703
Cape Girardeau County (573) 332-0416
MR. JOHN EUGENE NIMMO
Counselor (Mental Health)
340 S BROADVIEW ST
CAPE GIRARDEAU, MO 63703
Cape Girardeau County (573) 332-0416
BRENDA GAUSE RN
Registered Nurse
340 S BROADVIEW ST
CAPE GIRARDEAU, MO 63703
Cape Girardeau County (573) 332-0416
JANICE L RUESLER LPC
Counselor (Professional)
340 S BROADVIEW ST
CAPE GIRARDEAU, MO 63703
Cape Girardeau County (573) 332-0416
GIBSON CENTER FOR BEHAVIORAL CHANGE
Clinic/Center (Rehabilitation, Substance Use Disorder)
340 S BROADVIEW ST
CAPE GIRARDEAU, MO 63703
Cape Girardeau County (573) 332-0416
MS. JODY PETZOLDT M.A.
Counselor (Professional)
340 S BROADVIEW ST
CAPE GIRARDEAU, MO 63703
Cape Girardeau County (573) 332-0416
MECHELLE ABERNATHY LPN
Licensed Practical Nurse
340 S BROADVIEW ST
CAPE GIRARDEAU, MO 63703
Cape Girardeau County (573) 332-0416

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 Tina Fuller's NPI number?

The NPI number for Tina Fuller is 1659879096. It was assigned to this individual provider in the NPPES registry on January 31, 2018.

Where is Tina Fuller located?

Tina Fuller practices at 340 S Broadview St, Cape Girardeau, MO 63703. The listed phone number is (573) 332-0416.

What is Tina Fuller'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 Tina Fuller was last updated on February 7, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.