Individual
CHRIS A FUGUNT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1114 W MADISON AVE, ATHENS, TN 37303-4150
(423) 745-1411
Mailing address
PO BOX 220, ATHENS, TN 37371-0220
(423) 424-3695
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APN10918
TN
367500000X
Certified Registered Nurse Anesthetist
RN96805
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3631131
—
TN
01
—
4142846
BLUE CROSS BLUE SHIELD
TN
01
—
P00363036
RR MEDICARE
TN
Enumeration date
11/02/2006
Last updated
10/26/2007
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