MRS. KATHLEEN MARIE FULLER NP NPI 1689638371

NPI Information

NPI: 1689638371
Provider Name: MRS. KATHLEEN MARIE FULLER, NP
Classification: Nurse Practitioner - 363LX0001X
Entity Type: Individual

Specialization: Obstetrics & Gynecology

PECOS Registration: Yes

Address:
300 CONGRESS ST
SUITE 102
QUINCY, MA
ZIP 02169
Phone: (617) 479-6636
Get Directions

MRS. Kathleen Marie Fuller, NP is an obstetrics and gynecology nurse practitioner in Quincy, MA. MRS. Kathleen Marie Fuller, NP NPI is 1689638371. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

300 CONGRESS ST
SUITE 102
QUINCY, MA
ZIP 02169-907
Phone: (617) 479-6636
Fax: (617) 376-0435

The NPI 1689638371 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 4/12/2006 and was last updated on 11/22/2016.

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	363LX0001X	Nurse Practitioner	Obstetrics & Gynecology	RN2297885	MASSACHUSETTS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	RN2297885	OTHER	MASSACHUSETTS	NURSE PRACTITIONER LICENSE

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: 4/28/2024

NPI Synchronization or Removal

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