Individual
KELSEY LYNN FULLERTON
Active
Individual
KELSEY LYNN FULLERTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGACNP
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
2021086004
MI
363LA2100X
Acute Care Nurse Practitioner
Primary
4704344689
MI
363LG0600X
Gerontology Nurse Practitioner
71012272A
IN
Other
Enumeration date
10/29/2021
Last updated
04/19/2023
Update your record
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