Kelli Amanda Fugate, is a
Licensed Practical Nurse based in Maybee, Michigan. Kelli Amanda Fugate is licensed to practice in Michigan (license number 4703125158) and her current practice location is
7755 Frederick St, Maybee, Michigan. She can be reached at her office (for appointments etc.) via phone at
(734) 217-9694.
NPI number for Kelli Amanda Fugate is 1023845120 and her current mailing address is 7755 Frederick St, Maybee, Michigan. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1023845120.
Provider's Profile
Full Name | Kelli Amanda Fugate |
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Gender | Female |
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Speciality | Licensed Practical Nurse |
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Location | 7755 Frederick St, Maybee, Michigan |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1023845120
- Provider Enumeration Date: 09/14/2024
- Last Update Date: 09/14/2024
Medical Identifiers
Medical identifiers for Kelli Amanda Fugate such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1023845120 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
164W00000X | Licensed Practical Nurse | 4703125158 (Michigan) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kelli Amanda Fugate is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Kelli Amanda Fugate, 7755 Frederick St, Maybee, MI 48159-9697 Ph: (734) 217-9694 | Kelli Amanda Fugate, 7755 Frederick St, Maybee, MI 48159-9697 Ph: (734) 217-9694 |
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