Provider Demographics
NPI:1891394474
Name:GULLETT, KARRINGTON CLINE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:KARRINGTON
Middle Name:CLINE
Last Name:GULLETT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:263 WINDY ACRES DR
Mailing Address - Street 2:
Mailing Address - City:WEST LIBERTY
Mailing Address - State:KY
Mailing Address - Zip Code:41472-2098
Mailing Address - Country:US
Mailing Address - Phone:606-477-5454
Mailing Address - Fax:
Practice Address - Street 1:263 WINDY ACRES DR
Practice Address - Street 2:
Practice Address - City:WEST LIBERTY
Practice Address - State:KY
Practice Address - Zip Code:41472-2098
Practice Address - Country:US
Practice Address - Phone:606-477-5454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-23
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1140654163W00000X
KY3015397363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse