Active NPI
Kristen Lynn Fulmer, MS RD CD
- Registered Dietitian
- Milwaukee, WI
National Provider Identifier
1144738741
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 3041-29
- Practice address
- 2900 W Oklahoma Ave
Milwaukee, WI 53215-4330 - Phone
- (414) 646-6722
- NPI assigned
- Jan 17, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 3041-29 | WI | Primary |
Addresses
Primary practice location
2900 W Oklahoma Ave
Milwaukee, WI 53215-4330
Mailing address
10400 75TH St
Kenosha, WI 53142-7884
Phone (262) 948-6692
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3041-29 | WI | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1516147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700611200000",
"number": "1144738741",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10400 75TH ST",
"city": "KENOSHA",
"state": "WI",
"postal_code": "531427884",
"telephone_number": "262-948-6692"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2900 W OKLAHOMA AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532154330",
"telephone_number": "414-646-6722"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULMER",
"first_name": "KRISTEN",
"middle_name": "LYNN",
"credential": "MS RD CD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-01-17",
"last_updated": "2023-11-22",
"certification_date": "2023-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WI",
"license": "3041-29",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.