Individual
KATHRYN L CHARLTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
444 FOUR STATES DR STE 1, GALENA, KS 66739-4325
(620) 783-4441
Mailing address
444 FOUR STATES DR STE 1, GALENA, KS 66739-4325
(620) 834-4414
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
53-80753-042
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200077810A
—
OK
05
—
200371350A
—
KS
05
—
427385109
—
MO
01
—
431560263
TRICARE WEST
—
01
—
P00689771
RR MEDICARE
—
Enumeration date
06/23/2006
Last updated
01/21/2022
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