Individual
JUSTIN K FUQUA
Active
Individual
JUSTIN K FUQUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1031265
TX
367500000X
Certified Registered Nurse Anesthetist
2024010874
MO
367500000X
Certified Registered Nurse Anesthetist
210093
LA
367500000X
Certified Registered Nurse Anesthetist
RN783971
PA
Other
Enumeration date
12/19/2019
Last updated
08/06/2025
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