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

Nino Fuller, AGACNP-BC

Individual provider Nurse Practitioner · NPI 1962974469

Nino Fuller, AGACNP-BC is a Nurse Practitioner in Henderson, Texas. Qualified in 2018, 8 years ago. Practices with Etmc Physician Group, Inc, a 376-clinician group and accepts Medicare assignment. Licensed in Georgia, Texas and Virginia.

Years since qualifying
8
Licensed in
GA, TX, VA
In the registry since
2018
Specialties on file
6
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Practice location Address checks out

300 Wilson St
Henderson, TX 75652-5956
Phone: (903) 655-6536
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence AP140425 (TX)
Nurse Practitioner Taxonomy 363L00000X · Licence 0024180028 (VA)
Acute Care Nurse Practitioner Taxonomy 363LA2100X · Licence AP140425 (TX)
Acute Care Nurse Practitioner Taxonomy 363LA2100X · Licence GAA-NP000340 (GA)
Acute Care Nurse Practitioner Taxonomy 363LA2100X · Licence 866207 (TX)
Acute Care Nurse Practitioner Taxonomy 363LA2100X · Licence 0024180028 (VA)

Record details

NPI number1962974469
Entity typeIndividual (Type 1)
GenderFemale
Credentials AGACNP-BC
Sole proprietorNo
NPI enumeratedDecember 20, 2018
Last updated in NPPESNovember 30, 2022
Certification dateNovember 30, 2022

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Etmc Physician Group, Inc. — 376 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

Other providers in Henderson