Individual
KATHRYN M FULGHUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
3600 E HARRY ST, WICHITA, KS 67218-3713
(316) 689-5475
(316) 691-6772
Mailing address
12114 E MAINSGATE ST, WICHITA, KS 67226-4528
(316) 619-7729
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
53-75971
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1101723267
MEDICARE
—
05
—
2010725400A
—
KS
Enumeration date
05/14/2013
Last updated
09/12/2025
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