Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

MS. Keisha Musu Fully, LPN

Individual provider Licensed Practical Nurse · NPI 1104773803

MS. Keisha Musu Fully, LPN is a Licensed Practical Nurse in Staten Island, New York. Practices as a sole proprietor. Licensed in New Jersey and New York.

Licensed in
NJ, NY
In the registry since
2026
Specialties on file
2
What do these letters mean?
LPN — Licensed Practical Nurse
A licensed nurse who works under the direction of an RN or physician.

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Practice location Address checks out

180 Park Hill Ave Apt 5D
Staten Island, NY 10304-4708
Phone: (347) 596-1489
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Licensed Practical Nurse (primary) Taxonomy 164W00000X · Licence 352421 (NY)
Licensed Practical Nurse Taxonomy 164W00000X · Licence 26NP49873900 (NJ)

Record details

NPI number1104773803
Entity typeIndividual (Type 1)
GenderFemale
Credentials LPN
Sole proprietorYes
NPI enumeratedMarch 12, 2026
Last updated in NPPESMarch 12, 2026
Certification dateMarch 12, 2026

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