Individual
DUSTIN FULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1265 UNION AVE, MEMPHIS, TN 38104-3415
(901) 725-5846
Mailing address
6060 PRIMACY PKWY, SUITE 241, MEMPHIS, TN 38119-5745
(901) 725-5846
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
171165
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
19665
TN
Other
Enumeration date
11/19/2014
Last updated
11/15/2016
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