Individual
CECIL FULLER II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
315 HOSPITAL DR, MADISON, TN 37115-5030
(615) 868-6503
Mailing address
2024 CRENCOR DR, GOODLETTSVILLE, TN 37072-4306
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1-162112
AL
367500000X
Certified Registered Nurse Anesthetist
1-162112
AL
Other
Enumeration date
10/21/2021
Last updated
10/16/2025
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