Fuller, Catina
Fuller, Catina is an individual health care provider with primary practice located at 1935 Lakeland Dr Ste 900 , Jackson MS 39216-5028. She recently has only one registered license in Nursing Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Fuller, Catina can be contacted via phone (601) 718-2468.Contact Information
Primary practice address
1935 Lakeland Dr Ste 900
Jackson MS 39216-5028
Phone: (601) 718-2468
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Providers / Addiction (Substance Use Disorder) | 163WA0400X | 901240 | Mississippi |
Profile Details
| NPI number | 1407430390 |
|---|---|
| LBN Legal business name | Fuller, Catina |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 7th, 2021 |
| Last updated | May 7th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1407430390 | NPPES |
| Mississippi | MEDICAID | 64126 |
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