Individual provider · Type 1 NPI

Kelly Kathleen Wolfe Fromuth, AGPCNP-PP

Primary Care Nurse Practitioner · Portland, OR

NPI number 1689052201 Active

Practice location

5100 SW Macadam Ave, #200
Portland, OR 97239-6102

Mailing address

5100 S Macadam Ave Ste 200
Portland, OR 97239-3827

Specialties and licenses

TaxonomyCodeLicense
Adult Health Nurse Practitioner 363LA2200X201501921NP-PP (OR)
Gerontology Nurse Practitioner 363LG0600X201501921NP-PP (OR)
Primary Care Nurse Practitioner Primary 363LP2300X201501921NP-PP (OR)

Primary Care Nurse Practitioner: Definition to come...

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About NPI 1689052201

Kelly Kathleen Wolfe Fromuth, AGPCNP-PP's National Provider Identifier is 1689052201, issued on May 14, 2015. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Portland, OR. The record was last updated on Dec 7, 2021.