Individual
CHANDLER FUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1201 BISHOP ST, UNION CITY, TN 38261-5403
(731) 285-2410
Mailing address
486 REVELL RD, DYERSBURG, TN 38024-7564
(731) 446-9616
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
235795
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
36458
TN
Other
Enumeration date
04/22/2024
Last updated
01/08/2025
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