Individual
KATRINA E FULMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
4665 DOUGLAS CIR NW, SUITE 101, CANTON, OH 44718-3673
(330) 499-5700
(330) 498-4229
Mailing address
PO BOX 182255, COLUMBUS, OH 43218-2255
(614) 430-5723
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN148264
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000135932
ANTHEM
—
05
—
0751557
—
OH
Enumeration date
05/15/2006
Last updated
08/21/2007
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