Healthcare Provider Details

I. General information

NPI: 1912945890
Provider Name (Legal Business Name): JAMES PAUL FULTON CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 N LA CHOLLA BLVD
TUCSON AZ
85741-3529
US

IV. Provider business mailing address

723 MEMORIAL ST
PROSSER WA
99350-1524
US

V. Phone/Fax

Practice location:
  • Phone: 877-848-1457
  • Fax:
Mailing address:
  • Phone: 509-786-2222
  • Fax: 509-786-6612

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number342860
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAP30006595
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN00120658
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: