National Provider Identifier Database

JALISA FULLER
Driver

A person employed to operate a motor vehicle as a carrier of persons or property.


Contact Information

JALISA FULLER
1621 WILLIAMSBURG DR
BOSSIER CITY, LA71112-3165
Phone: 318-730-2368
Fax:
Website:
Specialty Taxonomy Code
* Driver 172A00000X

* Indicates primary specialty

NPI Profile & details for JALISA FULLER

NPI Number 1982270088
Credentials
Entity Individual
Enumeration date 05/28/2021
Last updated 05/28/2021 - About 5 years ago
Sole proprietor1 No
Identifiers
  • LA License #: 009494849
  • LA Medicaid: 843382246
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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