Individual
JUSTIN SCOTT FULKERSON
Active
Individual
JUSTIN SCOTT FULKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ACNP-BC, CRNA
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
18087
SC
367500000X
Certified Registered Nurse Anesthetist
11018636
FL
367500000X
Certified Registered Nurse Anesthetist
209-009025
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
209009025
IL
Other
Enumeration date
08/24/2011
Last updated
09/09/2025
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