Individual
MS. TANGELA FUQUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
14509 CAPITAL DRIVE, PLAINFIELD, IL 60544-4415
(815) 690-5946
Mailing address
14509 CAPITAL DR, PLAINFIELD, IL 60544-4415
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
0024174710
VA
367500000X
Certified Registered Nurse Anesthetist
041291415
IL
367500000X
Certified Registered Nurse Anesthetist
28182264A
IN
367500000X
Certified Registered Nurse Anesthetist
Primary
R190737
MD
Other
Enumeration date
04/18/2006
Last updated
12/08/2025
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