| Selena Fuller, NP | |
|
2779 Cobb Pkwy Nw, Kennesaw, GA 30152-3437 | |
| (678) 732-1500 | |
| Not Available |
| Full Name | Selena Fuller |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 15 Years |
| Location | 2779 Cobb Pkwy Nw, Kennesaw, Georgia |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598102733 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | RN172405 (Georgia) | Primary |
| 207Q00000X | Family Medicine | RN172405 (Georgia) | Secondary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Piedmont Professional Services Llc | 8921176231 | 171 |
| Entity Name | Piedmont Professional Services LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1104088905 PECOS PAC ID: 8921176231 Enrollment ID: O20081014000187 |
| Mailing Address | Practice Location Address |
|---|---|
| Selena Fuller, NP 2779 Cobb Pkwy Nw, Kennesaw, GA 30152-3437 Ph: Not Available | Selena Fuller, NP 2779 Cobb Pkwy Nw, Kennesaw, GA 30152-3437 Ph: (678) 732-1500 |
Lisa Vivienne Poling, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1000 Chastain Rd Nw, Kennesaw, GA 30144 Phone: 678-797-2844 Fax: 678-797-2827 |
Ms. Tanya S Wilcox, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1770 Dennis Kemp Ln Nw, Kennesaw, GA 30152 Phone: 770-515-9000 |
Khadijah Fife Phillips, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: Po Box 441065, Kennesaw, GA 30160 Phone: 516-782-8988 |
Mrs. Martricia Meshonna Turner, N.P. Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3805 Cherokee St Nw, Kennesaw, GA 30144 Phone: 770-426-5666 Fax: 770-426-6205 |
Ms. Stacey Levison, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2782 Cobb Pkwy Nw, Kennesaw, GA 30152 Phone: 770-590-8181 |
Shakira Lynn, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2782 N Cobb Pkwy, Kennesaw, GA 30152 Phone: 877-993-4321 |
Sarah Mitchum Keen, RN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1770 Dennis Kemp Ln Nw, Kennesaw, GA 30152 Phone: 770-515-9000 |