Provider Demographics
NPI:1952032864
Name:FULBRIGHT, KENDRA JEAN (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:KENDRA
Middle Name:JEAN
Last Name:FULBRIGHT
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8089 W GASSAWAY RD
Mailing Address - Street 2:
Mailing Address - City:HULBERT
Mailing Address - State:OK
Mailing Address - Zip Code:74441-2446
Mailing Address - Country:US
Mailing Address - Phone:918-207-6159
Mailing Address - Fax:
Practice Address - Street 1:8089 W GASSAWAY RD
Practice Address - Street 2:
Practice Address - City:HULBERT
Practice Address - State:OK
Practice Address - Zip Code:74441-2446
Practice Address - Country:US
Practice Address - Phone:918-207-6159
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-21
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK207349363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily