Healthcare Provider Details

I. General information

NPI: 1003110453
Provider Name (Legal Business Name): KRISTY L FUHRKEN CFNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2010
Last Update Date: 12/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

819 E MAIN AVE
ROBSTOWN TX
78380-3134
US

IV. Provider business mailing address

14041 NORTHWEST BLVD STE 1
CORPUS CHRISTI TX
78410-5137
US

V. Phone/Fax

Practice location:
  • Phone: 361-387-1200
  • Fax: 361-387-1300
Mailing address:
  • Phone: 361-767-9963
  • Fax: 361-767-1382

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number678538
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: