Itasca Healing Medical Practice
NPI 1023867546ActiveOrganization· Nurse Practitioner· Nacogdoches, TX
Nurse Practitioner in Nacogdoches, Texas, registered in NPPES in May 2024. The authorized official on file is Suzanna Itasca Fuller, NP, Owner/ Provider. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1023867546 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 16, 2024 |
| Last updated in NPPES | Aug 5, 2026 |
| Certified by provider | Aug 5, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner Primary | 363L00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (TX) |
|---|
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