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Individual

MRS. KATHERINE ALLGOOD FULTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NNP

Contact information

Practice address
5 RIVER BEND PL, SUITE C, FLOWOOD, MS 39232-7618
(601) 957-7345
(769) 251-5429
Mailing address
PO BOX 320039, FLOWOOD, MS 39232-0039
(601) 957-7345
(769) 251-5924

Taxonomy

Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
R880059
MS
363LN0005X
Critical Care Neonatal Nurse Practitioner
R880059
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01955831
MS
Enumeration date
08/13/2013
Last updated
05/16/2016
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