Individual provider · Type 1 NPI

Tina Fuller, LPN

Licensed Practical Nurse · Cape Girardeau, MO

NPI number 1659879096 Active

Practice location

340 S Broadview St
Cape Girardeau, MO 63703-5703

Fax (573) 335-2698

Mailing address

8206 Fendale Dr
St. Louis, MO 63123-3304

Specialties and licenses

TaxonomyCodeLicense
Licensed Practical Nurse Primary 164W00000X2006025670 (MO)

Licensed Practical Nurse: An individual 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.

7 other providers at this address

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About NPI 1659879096

Tina Fuller, LPN's National Provider Identifier is 1659879096, issued on Jan 31, 2018. The primary taxonomy on file is Licensed Practical Nurse (164W00000X), and the practice location is in Cape Girardeau, MO. The record was last updated on Feb 7, 2026.