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Individual

MR. AUSTIN FULTZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA DNAP

Contact information

Practice address
250 PARK ST, BOWLING GREEN, KY 42101-1760
(270) 745-1111
Mailing address
PO BOX 2697, BOWLING GREEN, KY 42102-7697
(270) 745-1111
(270) 745-1026

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3017299
KY

Other

Enumeration date
10/07/2021
Last updated
02/09/2022
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