Active NPI
Kris Yvonne Fultz, RN
- Long-Term Care Clinical Nurse Specialist
- Hanover, IN
National Provider Identifier
1417524018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Long-Term Care Clinical Nurse Specialist
- License
- 28201115A
- Practice address
- 188 Thornton Rd
Hanover, IN 47243-9714 - Phone
- (812) 866-8396
- NPI assigned
- Jun 10, 2021
- Last updated
- Jun 10, 2021
- 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 |
|---|---|---|---|---|
| Long-Term Care Clinical Nurse Specialist | 364SL0600X | 28201115A | IN | Primary |
Addresses
Primary practice location
188 Thornton Rd
Hanover, IN 47243-9714
Mailing address
188 Thornton Rd
Hanover, IN 47243-9714
Phone (812) 866-8396
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
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28201115A | IN | MD | Long-Term Care Clinical Nurse Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623283200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623283200000",
"number": "1417524018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "188 THORNTON RD",
"city": "HANOVER",
"state": "IN",
"postal_code": "472439714",
"telephone_number": "812-866-8396"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "188 THORNTON RD",
"city": "HANOVER",
"state": "IN",
"postal_code": "472439714",
"telephone_number": "812-866-8396"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULTZ",
"first_name": "KRIS",
"middle_name": "YVONNE",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-10",
"last_updated": "2021-06-10",
"certification_date": "2021-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "364SL0600X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist, Long-Term Care",
"state": "IN",
"license": "28201115A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hanover, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.