MR. KENNETH MICHAEL FULLER FNP NPI 1538508163

NPI Information

NPI: 1538508163
Provider Name: MR. KENNETH MICHAEL FULLER, FNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
518 ENCHANTED HOLLOW DR
SPRING, TX
ZIP 77388
Phone: (832) 466-3432
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MR. Kenneth Michael Fuller, FNP is a family nurse practitioner in Spring, TX. MR. Kenneth Michael Fuller, FNP NPI is 1538508163. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

518 ENCHANTED HOLLOW DR
SPRING, TX
ZIP 77388-108
Phone: (832) 466-3432

The NPI 1538508163 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/17/2013 and was last updated on 6/17/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	594667	TEXAS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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