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Individual

MS. ABIGAIL NICOLE KOETTING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSN, APRN, FNP-BC

Contact information

Practice address
10 S HOSPITAL DR, FULTON, MO 65251-2510
(573) 592-6550
Mailing address
210 NE TUDOR RD, LEES SUMMIT, MO 64086-5696
(888) 256-3814
(888) 256-9054

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
2001015695
MO
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2001015695
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1528392024
MO
Enumeration date
09/30/2009
Last updated
03/30/2023
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