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

Mrs. Kimberly Fuller, MSN, ACNP-BS

Individual provider Acute Care Nurse Practitioner · NPI 1083860324

Mrs. Kimberly Fuller, MSN, ACNP-BS is a Nurse Practitioner in Vicksburg, Mississippi. Qualified in 2008, 18 years ago. Practices with Quad Intermed Company LLC, a 42-clinician group and accepts Medicare assignment. Licensed in Mississippi.

Years since qualifying
18
Licensed in
MS
In the registry since
2008
Specialties on file
2
What do these letters mean?
MSN — Master of Science in Nursing
A graduate nursing degree, usually held alongside an advanced practice licence.

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Practice location Address checks out

2100 Highway 61 N
Vicksburg, MS 39183-8211 Not confirmed with CMS for 17 years — call before visiting
Phone: (601) 883-5000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence R853474 (MS)
Emergency Medicine Physician Taxonomy 207P00000X · Licence R853474 (MS)

Record details

NPI number1083860324
Entity typeIndividual (Type 1)
GenderFemale
Credentials MSN , ACNP-BS
Sole proprietorNo
NPI enumeratedAugust 18, 2008
Last updated in NPPESMarch 16, 2009

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Quad Intermed Company Llc — 42 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients302
Services billed 2,664 a service is one billed item, such as a visit, a test or a procedure
Average patient age73

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician. Those with a page here are linked.

  • Merit Health River Region Hospital · Vicksburg, MS · listed as River Region Health System
  • Adoration Home Health Home health agency · Vicksburg, MS

Colleagues at Quad Intermed Company LLC

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 42 clinicians in the practice; 12 are shown here.

Other providers in Vicksburg