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

Nichole Leshawn Fuller

Individual provider Gerontology Nurse Practitioner · NPI 1720584899

Nichole Leshawn Fuller is a Nurse Practitioner in Rochester Hills, Michigan. Qualified in 2017, 9 years ago. Practices with Halo Medical Group PLLC, a 17-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
9
Licensed in
MI
In the registry since
2018
Specialties on file
2

Practice location Address checks out

1428 Leupp Ct
Rochester Hills, MI 48307-3021
Phone: (313) 492-8911
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 4704280454 (MI)
Gerontology Nurse Practitioner Taxonomy 363LG0600X · Licence 4704280454 (MI)

Record details

NPI number1720584899
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 5, 2018
Last updated in NPPESApril 5, 2018

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Halo Medical Group Pllc — 17 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Rochester Hills