Kathleen Fullerton, FNP-C
Nurse Practitioner, Family in North Kansas City, MO. Individual provider (NPI-1).
NPI number1891362091
StatusActive
Last updated in NPPESApr 14, 2022
Details
- NPI
- 1891362091
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Kathleen Fullerton
- Credential
- FNP-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 7, 2021
- Certification date
- Apr 14, 2022
- Last updated
- Apr 14, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 2022006640 | MO | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | 143082 | MO | |
| 363LF0000X | Nurse Practitioner, Family | 143082 | MO |
Practice location
2700 Clay Edwards Dr Ste 240North Kansas City, MO 64116-3254
Phone 816-691-2021 · Fax 816-346-7690
Mailing address
2700 Clay Edwards Dr Ste 240North Kansas City, MO 64116-3254
Phone 816-691-2021 · Fax 816-346-7690
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