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General NPI Number Information
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NPI Number | 1174811046
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Entity Type | Individual
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Provider Name | ROSE KIM CHANG HULL NP
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Gender | Female
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Dates
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Enumeration Date | 07/13/2011
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Last Update Date | 06/15/2016
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Provider Practice Location Address
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Address Line | 2823 FRESNO ST
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City | FRESNO
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State | CA
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Zip | 93721-1324
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Country | US
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Telephone | 559-499-6439
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Fax | 559-499-6441
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Provider Business Mailing Address
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Address Line | 1524 W LACEY BLVD STE 101
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City | HANFORD
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State | CA
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Zip | 93230-5990
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Country | US
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Telephone | 559-537-0305
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Fax | 559-537-0307
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN718940
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | NP20843
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License Number State | CA
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