Individual
ANDREA MARIE FULLERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1515 S CLIFTON, STE 400, WICHITA, KS 67208
(316) 636-1550
(316) 689-9769
Mailing address
PO BOX 8035, WICHITA, KS 67208-0035
(316) 689-9135
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
046772
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003719131
MEDICARE
—
01
—
200429620A
OK MEDICAID
OK
05
—
200865920A
—
KS
Enumeration date
06/15/2007
Last updated
02/07/2014
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us