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General NPI Number Information
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NPI Number | 1528392024
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Entity Type | Individual
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Provider Name | ABIGAIL NICOLE KOETTING MSN, APRN, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 09/30/2009
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Last Update Date | 03/30/2023
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Provider Practice Location Address
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Address Line | 10 S HOSPITAL DR
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City | FULTON
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State | MO
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Zip | 65251-2510
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Country | US
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Telephone | 573-592-6550
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Fax |
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Provider Business Mailing Address
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Address Line | 210 NE TUDOR RD
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City | LEES SUMMIT
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State | MO
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Zip | 64086-5696
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Country | US
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Telephone | 888-256-3814
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Fax | 888-256-9054
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2001015695
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 2001015695
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License Number State | MO
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