Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Destiny Marie Fullen

Individual provider Family Nurse Practitioner · NPI 1588517619

Destiny Marie Fullen is a Nurse Practitioner in Bardstown, Kentucky. Qualified in 2025, 1 year ago. Practices with Kiosk Medicine Kentucky LLC, a 171-clinician group and accepts Medicare assignment. Licensed in Kentucky.

Years since qualifying
1
Licensed in
KY
In the registry since
2026
Specialties on file
2
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Practice location Address checks out

102 W John Rowan Blvd
Bardstown, KY 40004-2663
Phone: (502) 348-7880
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Nurse Practitioner (primary) Taxonomy 363LP2300X · Licence 4047688 (KY)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 4047688 (KY)

Record details

NPI number1588517619
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedFebruary 18, 2026
Last updated in NPPESMarch 7, 2026
Certification dateMarch 7, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Kiosk Medicine Kentucky Llc — 171 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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