Individual
KATELYN FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
201 STATE STREET, ERIE, PA 16550
(814) 877-6000
Mailing address
11781 LEE JACKSON MEMOIRLA HWY, SUITE 550, FAIRFAX, VA 22033
(571) 777-5102
(703) 563-6256
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN626190
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
111233
PA
Other
Enumeration date
03/25/2016
Last updated
05/11/2020
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