Provider Demographics
NPI:1043812555
Name:FULTON, KATHERINE (PA-C)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:FULTON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:13466 VERA MCGOWAN RD
Mailing Address - Street 2:
Mailing Address - City:WALKER
Mailing Address - State:LA
Mailing Address - Zip Code:70785-8508
Mailing Address - Country:US
Mailing Address - Phone:225-380-1720
Mailing Address - Fax:225-380-1719
Practice Address - Street 1:13466 VERA MCGOWAN RD
Practice Address - Street 2:
Practice Address - City:WALKER
Practice Address - State:LA
Practice Address - Zip Code:70785-8508
Practice Address - Country:US
Practice Address - Phone:225-380-1720
Practice Address - Fax:225-380-1719
Is Sole Proprietor?:No
Enumeration Date:2020-11-10
Last Update Date:2021-09-07
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant