Charles Fuller CRNA

NPI 1063518934 - Nurse Anesthetist, Certified Registered - 367500000X

NPI Details
NPI 1063518934
Gender Male
Enumeration Date 09/16/2006
Last Updated 04/29/2008
Entity Type Individual
Active Over 10 years ago
Practice Location
LITCHFIELD MN, 55355-3340, US
Phone (320) 693-3242
Business Location
400 E 10TH ST
WACONIA MN, 55387-4552, US
Phone (952) 442-9770
Fax (952) 442-3630
Taxonomy Code 367500000X
License State Minnesota
License Number R064879-2
Remove 1063518934 NPI Number

According to our database, Charles Fuller CRNA NPI is 1063518934, taxonomy code is 367500000X and license number is R064879-2, license state is located at Minnesota. Charles Fuller CRNA physically located at 612 S Sibley Ave, Litchfield MN, 55355-3340. NPI Number Charles Fuller CRNA has the Individual type.

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1063518934 NPI number is provided on an as is basis without warranty of any kind. 1063518934 is maintained by the National Plan & Provider Enumeration System. The contents of Charles Fuller CRNA are for informational purposes only.