Basic Information
| Provider Information | |||||||||
| NPI: | 1538390414 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WHEELER-FULTON | ||||||||
| FirstName: | KATHRYN | ||||||||
| MiddleName: | IRENE | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | N.P. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3696 DANBRIDGE DR | ||||||||
| Address2: | |||||||||
| City: | LANSING | ||||||||
| State: | MI | ||||||||
| PostalCode: | 489069276 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5172906159 | ||||||||
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| Practice Location | |||||||||
| Address1: | 320 S STERLING ST | ||||||||
| Address2: | |||||||||
| City: | ASHLEY | ||||||||
| State: | MI | ||||||||
| PostalCode: | 488065110 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9898472621 | ||||||||
| FaxNumber: | 9898472008 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/27/2009 | ||||||||
| LastUpdateDate: | 11/01/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 4704224923 | MI | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.